ABSTRACT
<p><b>OBJECTIVE</b>To compare the medium- and long-term effect of pneumatic ballistic extracorporeal shock wave versus ultrasound-guided hormone injection in the treatment of plantar fasciitis.</p><p><b>METHODS</b>The clinical data were collected from patients with plantar fasciitis admitted to PLA General Hospital pain department from September, 2015 to February, 2017. The patients were randomly divided into ultrasound-guided drug injection group and shock wave group. The therapeutic parameters including the numerical rating scale (NRS) scores in the first step pain in the morning, American Orthopedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Scale, and thickness of the plantar fascia were monitored before and at 1 week, 1 month, 3 months, and 6 months after the treatment. The recurrence rate, effectiveness, and patient satisfaction were compared between the two groups at 6 months after the treatment.</p><p><b>RESULTS</b>Thirty-nine patients were enrolled in shock wave group and 38 patients in ultrasound group. The NRS scores in the first step pain in the morning were lowered after treatment in both groups (P<0.05), and the scores were significantly lower in ultrasound group than in shock wave group at 1 week and 1 month (P<0.01), but significantly higher in ultrasound group than in shock wave group at 3 and 6 months after treatment (P<0.05). The AOFAS functional scores were increased in both groups (P<0.05) at 6 months after treatment, was significantly lower in ultrasound group than in shock wave group than group B (90.44∓13.27 vs 75.76∓21.40; P<0.05). The effective rates in shock wave group and ultrasound group were 92.31% and 76.32%, respectively (P<0.05). Recurrence was found in 1 patient (2.56%) in shock wave group and in 8 (21.05%) in ultrasound group (P<0.05). The patient satisfaction scores were significantly higher in shock wave group than in ultrasound group (8.13∓2.67 vs 6.63∓3.75, P=0.048).</p><p><b>CONCLUSION</b>Pneumatic ballistic extracorporeal shock achieves better medium- and long-term outcomes than ultrasound-guided hormone injection in the treatment of plantar fasciitis.</p>
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the ability of pleth variability index (PVI) in predicting fluid responsiveness in mechanically ventilated patients under general anesthesia.</p><p><b>METHODS</b>From August to November 2009, 25 patients were enclosed in this study following anesthesia induction. PVI was continuously displayed by the Masimo Radical 7. All patients were also monitored with Vigileo/FloTrac system. Haemodynamic data such as cardiac index (CI), stroke volume variability (SVV), mean arterial pressure, heart rate, central venous pressure, PVI, perfusion index were recorded before and after volume expansion (hetastar 6%, 7 ml/kg). Fluid responsiveness was defined as an increase in CI ≥ 15% (ΔCI ≥ 15).</p><p><b>RESULTS</b>SVV and PVI were significantly higher in the responders (16.0% ± 2.6% and 20.5% ± 3.7%) than those in non-responders (11.6% ± 1.4% and 13.8% ± 2.6%) respectively (P < 0.05). The SVV threshold of 13.5% before volume expansion was able to discriminate the responders from the non-responders with a sensitivity of 88.2% and a specificity of 87.5%. The threshold for PVI was 15.5%, the same sensitivity of 88.2% and specificity of 87.5% were obtained. There was a significant relationship between PVI before volume expansion and change in CI after volume expansion (r = 0.683, P < 0.01), the same as the changes of SVV (r = 0.600, P < 0.01).</p><p><b>CONCLUSION</b>PVI as a new dynamic indices can predict fluid responsiveness non-invasively in mechanically ventilated patients during general anesthesia.</p>