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Objective: To introduce the construction idea and function for establishing China Cardiovascular Surgery Registry (CCSR)database and to provide a reference for domestic congener databases. Methods: Using peer database as reference, taking current status of cardiovascular surgery registry and hardware in our country with the necessity of international communication, we worked on a variables selection, metadata instruction, logic rules, case report form develpment and finally established a web-based, multi-functional database that enabled cross-database and international merging of data, forming a national intelligent data-exchanging platform for cardiovascular surgery. Results:CCSR database has over 300 variables of multiple topics including basic information, risk factors, medical procedures and endpoint events. Taking clinical and association data exchange standards as reference, it may conduct cross-discipline data connection, record important peri-operative information in relevant patients and meanwhile, it has the functions of automatic logic check, data report, statistical study, data export and importing the electronic medical records. Conclusion:CCSR database is a national platform accord with current status of Chinese cardiovascular surgery and characteristics, meanwhile it gives consideration to international communication and data exchange; which may play a important role in improving medical care and clinical investigation.
ABSTRACT
Objective: To introduce the construction idea and function for establishing China Cardiovascular Surgery Registry (CCSR)database and to provide a reference for domestic congener databases. Methods: Using peer database as reference, taking current status of cardiovascular surgery registry and hardware in our country with the necessity of international communication, we worked on a variables selection, metadata instruction, logic rules, case report form develpment and finally established a web-based, multi-functional database that enabled cross-database and international merging of data, forming a national intelligent data-exchanging platform for cardiovascular surgery. Results:CCSR database has over 300 variables of multiple topics including basic information, risk factors, medical procedures and endpoint events. Taking clinical and association data exchange standards as reference, it may conduct cross-discipline data connection, record important peri-operative information in relevant patients and meanwhile, it has the functions of automatic logic check, data report, statistical study, data export and importing the electronic medical records. Conclusion:CCSR database is a national platform accord with current status of Chinese cardiovascular surgery and characteristics, meanwhile it gives consideration to international communication and data exchange; which may play a important role in improving medical care and clinical investigation.
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<p><b>OBJECTIVE</b>To observe preliminary efficacy of decompressive unilateral improved transforaminal lumbar interbody fusion (TLIF) for the treatment of lumbar degenerative diseases.</p><p><b>METHODS</b>From August 2009 to December 2011, 28 patients with lumbar degenerative diseases were treated by decompressive unilateral improved TLIF,including 16 males and 12 females with an average of 61 (aged 46 to 71) years old,the courses of disease ranged from 6 months to 6 years. Among them, 20 cases suffered from lumbar spinal stenosis, 8 cases were lumbar disc herniation. Decompressive range included single segment in 24 cases,and double segments in 4 cases; 15 cases were performed operation on the left side, 13 cases on the right side. JOA lower back pain scoring system (29 points) were applied for evaluate preoperative and postoperative symptoms, physical signs and sphincteral functions;Visual analogue scale (VAS) were used to evaluate preoperative and postoperative low back pain.</p><p><b>RESULTS</b>All patients were followed up 6 to 28 (mean 14) months. Postoperative JOA score and VAS score were 17.9 +/- 2.2, 2.8 +/- 0.7 respectively,and preoperative JOA score and VAS score were 8.5 +/- 1.7, 8.6 +/- 1.2, respectively. There were significant meaning in JOA and VAS scores before and after operation (P < 0.05). Twenty-eight patients were all obtained intervertebral synostosis.</p><p><b>CONCLUSION</b>Decompressive unilateral improved TLIF for treatment of unilateral radicular lumbar spinal stenosis and lumbar disc herniation,which has advantages of minimally invasive,curative effects,decrease medical costs,is worthy spreading in clinical.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Decompression, Surgical , Lumbar Vertebrae , General Surgery , Spinal Diseases , General Surgery , Spinal Fusion , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the therapic choice of intertrochanteric fractures of femur in aged patient.</p><p><b>METHODS</b>From June 2006 to June 2010,58 patients with intertrochanteric fracture were treated with surgical methods. There were 25 males and 33 females, aged from 65 to 93 years old (averaged 79 years old). According to the Evans type, type I was in 30 cases, type II was in 28 cases. Of them, 25 patients were treated with hip replacement (group A) and 33 patients were treated with internal fixation (group B). The operative time, blood loss volume, the time of get out of bed, drainage volume, complications and function of joint motion were compared between two groups. According to Harris scoring to evaluate function of joint motion at the 3rd, 6th, 12th months after operation.</p><p><b>RESULTS</b>All patients were followed up more than 12 months (averaged 16.4 months). One patient in group A died of pneumonia one month later after operation and other patients live safely through peri-operation. The group B was better than that of group A at operative time, blood loss volume, drainage volume. In group A, 1 case died and 1 case got DVT, 2 cases got urinary tract infection and 1 case got pneumonia. While in group B, 1 case got bedsore, 1 case got coxa vara and 2 cases got urinary tract infection. The incidence rate of complication in group B was lower than that of group A (P < 0.05). According to Harris scoring system, at the 3rd, 6th,12th months after operation, Harris scoring in group A was respectively (78.43 +/- 5.32), (81.67 +/- 4.87), (87.66 +/- 4.01) scores and in group B was respectively (75.45 +/- 3.22), (76.33 +/- 4.12), (88.65 +/- 3.77) scores. There was statistical significance in Harris scoring at the 3rd, 6th months after operation between two groups (P < 0.05) and there was no statistical significance at the 12th months after operation (P > 0.05). At three months after operation, in group A,14 cases obtained excellent results, 5 good, 5 fair and 1 poor; and in group B, 8 cases obtained excellent results, 13 good, 9 fair and 3 poor. Six months later, in group A,18 excellent, 5 good, 2 fair and 0 poor, and in group B,10 excellent, 15 good, 6 fair and 2 poor. Twelve months later,in group A,18 excellent, 5 good, 1 fair and 1 poor; and in group B, 21 excellent, 9 good, 3 fair and 0 poor. Three and six months later after operation, the clinical effect in group A was better than that of group B (P < 0.05); but twelve months later, there was no significant differences between two groups (P > 0.05).</p><p><b>CONCLUSION</b>The internal fixation is especially the preferred method for the aged patient with intertrochanteric fractures. Hip replacement refer to pathologicalfracture caused by cancer, unheeded fracture abnormity, osteoprosis too serious to be treated by internal fixation or patients with ipsilateral symptomatic degenerative joint or revisions caused by failed internal fixation and severely intertrochanteric comminuted fractures and merged severely osteoporosis.</p>