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Objective@#To review and compare radiological parameters between degenerative lumbar kyphoscoliosis (DLKS) and degenerative lumbar kyphosis (DLK), and analyze the relationships between coronal and sagittal deformities and compensatory mechanisms of sagittal balance.@*Methods@#A total of 82 patients with lumbar degenerative deformities were enrolled for our radiographic study at Department of Spinal Surgery, Peking University People′s Hospital from January 2016 to May 2017. These patients were divided into two groups: DLKS group (39 patients) with lumbar coronal and sagittal deformities, and DLK group (43 patients) just with lumbar sagittal deformity. Complete spinopelvic radiographic parameters were compared.@*Results@#The Cobb angle and lumbar lordosis of DLKS group were (23.0±11.8)° and (18.2±12.1)°, while the lumbar lordosis of DLK group was (20.4±10.2)°. In DLKS group, Cobb angle had correlations with lumbar lordosis(r=-0.338, P=0.035), and central sacral vertical line distance had significant correlations with thoracolumbar junctional angle (r=0.488, P=0.002) . Moreover, no significant differences of all sagittal spinopelvic parameters were found between two groups (P>0.05). In DLKS group, significant correlations between lumbar lordosis and sacral slope (r=0.617, P=0.000), and correlations between lumbar lordosis and thoracic kyphosis(r=-0.363, P=0.023) were observed. In DLK group, lumbar lordosis showed significant correlations with thoracic kyphosis(r=-0.341, P=0.025) and sacral slope (r=0.772, P=0.000). According to Nash-Moe grading scale of apical vertebral rotation, 10 patients were with Ⅰ-Ⅱ grade while 29 patients with Ⅲ-Ⅴ grade in DLKS group.@*Conclusions@#Both as typical lumbar degenerative deformities, there are some correlations between scoliosis and kyphosis. However, coronal scoliosis may not influent sagittal morphological parameters for DLKS patients. Thoracic curve changes and pelvic backtilt are both important for maintaining the sagittal balance in patients with degenerative lumbar kyphoscoliosis.
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Objective To investigate the clinical effects and safety differences of endoscopic hormone injection by tympanic membrane puncture and eustachian tube in the treatment of patients with chronic secretory otitis media.Methods From January 2015 to September 2016,90 patients with chronic secretory otitis media in Zhoushan Hospital were chosen.They were randomly divided into two groups according to the digital table.The tympanic membrane puncture group (65 patients) was treated with hormone injection by tympanic membrane puncture and the eustachian tube group(65 patients) was treated with endoscopic hormone injection by eustachian tubeThe total clinical effective rate,the bone conduction threshold value in 1 kHz,2kHz,4kHz and 8kHz,the ETDQ-7 score and the levels of laboratory index before and after treatment,the secondary tympanic effusion rate and the recurrence rate with follow-up of both groups were compared.Results The total clinical effective rate of the tympanic membrane puncture group and eustachian tube group were 77.78％ and 93.33％,respectively.The total clinical effective rate of the eustachian tube group were significant higher than that of the tympanic membrane puncture group (x2 =9.84,P ＜ 0.05).The bone conduction threshold value in l kHz,2kHz,4kHz and 8kHz of the tympanic membrane puncture group after treatment were (10.42 ± 1.60) kHz,(12.86 ± 2.50) kHz,(16.09 ± 2.81) kHz,(15.26 ± 2.68) kHz,respectively.The bone conduction threshold value in 1kHz,2kHz,4kHz and 8kHz of the eustachian tube group after treatment were (9.75 ± 1.36) kHz,(11.13 ± 2.02) kHz,(14.82 ± 2.44) kHz,(13.78 ± 2.11) kHz,respectively.The bone conduction threshold value in 1kHz,2kHz,4kHz and 8kHz of the eustachian tube group after treatment were significant lower than those of the tympanic membrane puncture group and those before treatment(t =3.10,3.56,3.29,3.96,2.87,3.15,2.91,3.28,2.67,2.81,2.78,2.50,all P ＜ 0.05).The ETDQ-7 scores of the eustachian tube group after treatment were significant lower than those of the tympanic membrane puncture group and those before treatment(t =3.31,3.87,2.89,all P ＜ 0.05).The levels of laboratory index of the eustachian tube group after treatment were significant higher than those of the tympanic membrane puncture group and those before treatment (t =3.36,3.77,3.71,4.02,2.83,3.06,all P ＜ 0.05).The secondary tympanic effusion rate and the recurrence rate with follow-up of the eustachian tube group were significant lower than those of the tympanic membrane puncture group(x2 =9.87,12.33,10.67,all P ＜ 0.05).Conclusion Compared with endoscopic hormone injection by tympanic membrane puncture,endoscopic hormone injection by eustachian tube in the treatment of patients with chronic secretory otitis media possess the advantages including relieve the clinical symptoms,improve the bone conduction threshold and eustachian tube function,regulate the laboratory indexes and reduce the risk of recurrence and effusion.
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Objective To investigate the clinical value of gemstone spectral imaging (GSI) associated with patient-based low dose of contrast medium protocol in carotid CTA. Methods One hundred and twenty patients who were suspected with stenotic carotid artery or carotid plaque were prospectively enrolled in the study. All of them were divide into two groups by random number table. Group A (routine group): 60 were scanned with 120 kVp after the administration of moderate-concentration CM(320 mg/ml) with 5 ml/s injection velocity, Group B (low dose group):60 were scanned with GSI which was reconstructed using 50%ASiR after the administration of the same CM with 3 ml/s injection velocity. The contrast dose [(test bolus peak time +2 s – 5 s) × injection velocity] was calculated. Images of the two groups were compared in terms of arterial attenuation, signal-noise-ratio (SNR), contrast-to-noise ratio (CNR), and subjective image quality (IQ) score. The value of CT dose index volume (CTDIvol), dose length product (DLP) and effective dose (ED) was recorded, respectively. Data were analyzed by using independent samples t test or Mann-Whitney U test. Results The mean attenuation, noise, SNR, CNR, subjective image quality score, contrast dose, CTDIvol, DLP and ED of routine group was (363 ± 56)HU, (13 ± 4)HU, 30 ± 10, 38±13, 3.0 score, (69 ± 13) ml, 13.61 mGy,527 mGy · cm and 3.11 mSv, respectively. The above variables of low-dose-group was (378 ± 69) HU, (9 ± 4)HU, 48 ± 19, 62 ± 24, 2.0 score,(49 ± 7)ml, 12.72 mGy, 478 mGy · cm and 2.82 mSv, respectively. The mean attenuation and subjective IQ score of carotid artery had no significant differences statistically between two groups (P>0.05), respectively. The noise, SNR, CNR, contrast dose, CTDIvol, DLP and ED had significant differences statistically between two groups (P<0.05), respectively. Conclusion Compared with 120 kVp protocol, the use of GSI associated with patient-based low dose of contrast medium protocol in carotid CTA could provide equivalent image quality and higher SNR and CNR of carotid artery with a smaller amount of iodine and a lower radiation dose.