Treatment of the recurrent lumbar disc herniation:a comparison between endoscopic surgery and open surgery / 中国骨伤

<p><b>OBJECTIVE</b>To compare the clinical effect,advantages and disadvantages of endoscopic surgery and open surgery in treating the recurrent lumbar disc herniation.</p><p><b>METHODS</b>From August 2008 to December 2010,the data of 35 patients with recurrent lumbar disc herniation were retrospectively analyzed. The patients were divided into endoscopic surgery group and open surgery group according to operative methods. Fourteen patients in endoscopic surgery group were treated with transforaminal lumbar interbody fusion by micro-endoscopic discectomy (MED) and the other 21 patients in open surgery the group were treated with posterior lumbar interbody fusion by open surgery. All patients were fixed by vertebral pedicle screw. The operation time,volume of bleeding and drainage after operation,analgesic dosage and time in bed after operation were observed. Visual Analogue Scale(VAS),Japanese Orthopedic Association(JOA)and Chinese Oswestry Disability Index(CODI) were used to evaluate the clinical effects before and after operation.</p><p><b>RESULTS</b>There was no significant difference in operation time between two groups(P>0.05). Volume of bleeding and drainage after operation,analgesic dosage and time in bed after operation,VAS score in endoscopic surgery group was less than that of open surgery group (P<0.01). All patients were followed up for 1 year. There was no significant difference in JOA between two groups (P>0.05). CODI in endoscopic surgery group was better than that of open surgery group (P<0.01).</p><p><b>CONCLUSION</b>Both operative methods can obtain good clinical effects,but the transforaminal lumbar interbody fusion operation by micro-endoscopic discectomy (MED) has advantage of less traumatic and less pain,better functional recovery,it is a first choice in treating the recurrent lumbar disc herniation.</p>

Clinical control study on postmenopausal osteoporosis treated with embedding thread according to syndrome differentiation and medication / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the therapeutic efficacy of embedding thread according to staging and wholism syndrome differentiation and its effect on correlated indices of patients with postmenopausal osteoporosis.</p><p><b>METHODS</b>135 patients with postmenopausal osteoporosis were randomly assigned to the control group A (treated with Calcichew D3 Tablet), the control group B (treated with Calcichew D3 Tablet and Xianling Gubao Capsule), and the treatment group (treated with Calcichew D5 Tablet and embedding thread according to staging and wholism syndrome differentiation). The visual analogue scale (VAS), Chinese medicine syndrome integral, and the quality of life scale before treatment, 3 months after treatment, and 6 months after treatment were assessed. Changes of the lumbar bone mineral density (BMD) and the serum level of estradiol (E2) were also assessed before and after six-month treatment. And the therapeutic efficacy of each group was also assessed after 6 months of treatment.</p><p><b>RESULTS</b>Before treatment, there was no significant difference in scores of VAS, Chinese medicine syndrome integral and the quality of life scale, the.serum level of E2, and the lumbar BMD of the patients in three groups (all P>0.05). After three months of treatment, there was significant difference in scores of VAS, Chinese medicine syndrome integral and the quality of life scale of the patients in the three groups (all P<0.01). Of them, the improvement of the three indices in the control group A was the worst in three groups (P< 0.05, P<0.01). The VAS in the treatment group was superior to those in control group B (P<0.01). But the difference of Chinese medicine syndrome integral and the quality of life scale was insignificant in the three groups. After six months of treatment, significant difference was shown in the scores of VAS, Chinese medicine syndrome integral, or the quality of life scale of the patients in the three groups when compared with the corresponding index before treatment and after three months of treatment (all P<0.01). Of them the improvement of the three indices of patients in the treatment group and the control group B was better than that in the control group A (all P<0.01), and the improvement in the treatment group were superior to that in the control group B (P<0.05, P<0. 01). Significant difference was shown in the serum level of E2 and the lumbar BMD of the patients in the treatment group and the control group B when compared with before treatment of the same group (both P<0.01). But there was no difference in the control group A between before and after treatment, with better effects obtained in the treatment group and the control group B. And the serum level of E, of the patients in the treatment group after treatment was higher than that in the control group B (P<0.01), but there was no difference in the lumbar BMD. The therapeutic efficacy in the treatment group and the control group B were superior to that in the control group A (P<0.01, P<0.05), but no difference existed between the treatment group and the control group B.</p><p><b>CONCLUSIONS</b>The therapy of embedding thread according to staging and wholism syndrome differentiation could reduce the scores of VAS and Chinese medicine syndrome integral, enhance the serum lever of E2, the quality of life scale and the lumbar BMD of patients with postmenopausal osteoporosis. So it was an effective method.</p>

Postmenopausal osteoporosis of liver and kidney deficiency type treated with acupoint catgut embedding by stages / 中国针灸

<p><b>OBJECTIVE</b>To explore the better treatment of postmenopausal osteoporosis of liver and kidney deficiency type.</p><p><b>METHODS</b>One hundred and five cases were randomly divided into an observation group, a control group A and a control group B equally. In control group A, Calcichew D3 tablets were taken with oral administration; in control group B, Calcichew D3 tablets and Xianling Gubao capsule were taken with oral administration. In observation group, Calcichew D3 tablets and acupoint catgut embedding were applied; Shenshu (BL 23), Ganshu (BL 18), Jiaji (EX-B 2) and Weizhong (BL 40) etc. were selected at acute stage; Shenshu (BL 23) and Ganshu (BL 18) etc. were selected at remission stage, once every half a month and 6 months treatment in all. The Visual Analogue Scale (VAS), bone mineral density(BMD), estradiol (E2) and clinical effects were compared among groups.</p><p><b>RESULTS</b>After 3 and 6 months treatment, the scores of VAS were reduced among groups (all P < 0.01); the reduction in observation group and control group B was superior to that in control group A (all P < 0.001), and it was more obvious in observation group than that in control group B (both P < 0.001). After 6 months treatment, lumbar BMD and the serum level of Ez improved obviously in observation group and control group B (all P < 0.01). The comparison among groups after treatment showed that the BMD in observation group and control group B was superior o o that in control group A (P < 0.01, P < 0.05); the serum level of E2 in observation group was superior to that in control group B and control group A (both P < 0.001), and it in control group B was superior to that in control group A. The total effective rate was 91.4% (32/35) in observation group, superior to that in control group A (57.1%, 20/35); and the total effective rate was 82. 9% (29/35) in control group B, superior to that in control group A.</p><p><b>CONCLUSION</b>Calcichew D3 tablets and acupoint catgut embedding therapy can relieve the pain caused by postmenopausal osteoporosis of liver and kidney deficiency, improve the bone mineral density and serum level of estradiol; in brief, it is the better method.</p>

Controlled clinical trials on the treatment and prevention of shoulder and back fasciitis using horizontal bar exercises / 中国骨伤

<p><b>OBJECTIVE</b>To explore an exercise method for the prevention and treatment of the patients with shoulder and back fasciitis.</p><p><b>METHODS</b>From 2006.8 to 2008.3, 120 patients with shoulder and back fasciitis were randomly divided into control group (n = 60, including 21 females and 39 males, the average age was (47.0 +/- 12.0) years, and the average course of disease was (14.1 +/- 12.0) months) and treatment group (n = 60,including 19 females and 41 males, the average age was (43.7 +/- 9.9) years, and the average course of disease was (16.4 +/- 13.4) months). The patients in the control group received massage therapy and the ones in the treatment group were treated with massage therapy and horizontal bar exercise. After 3 weeks treatment, the curative effects of the patients in two groups were observed. All the patients were followed up for 6 to 26 months, the recurrence were observed.</p><p><b>RESULTS</b>After 3 weeks treatment, the scores of pain, sense of heaviness, strip sign, tenderness, shoulder and back function of the patients in two groups had significant differences compared with those before treatment (all P < 0.01). After treatment, the scores of pain, sense of heaviness, strip sign, tenderness, shoulder and back function of the patients in the treatment group were lower than those in the control group (P < 0.05). After 6 to 26 months following-up, the rate of recurrence in the treatment group was lower than that in the control group (P < 0.01).</p><p><b>CONCLUSION</b>Horizontal bar exercise is a simple, no expense and effective method in the prevention and treatment of shoulder and back fasciitis, which can improve the effect of the treatment and reduce the rate of recurrence.</p>

Analysis of intermediate and long term clinical effects on discectomy with diskoscope / 中国骨伤

<p><b>OBJECTIVE</b>To estimate intermediate and long term clinical effects of lumbar intervertebral disc herniation on discectomy with diskoscope.</p><p><b>METHODS</b>A hundred and nine patients with lumbar intervertebral disc herniation were retrospectively analyzed. The patietnts were operated with diskoscope. There were 61 males and 48 females. The age was from 25 to 68 years old with an average of 37.7 years. The affected region of patients were L(3,4) (5 cases), L(4,5) (42 cases), L5S1 (49 cases), L(4.5) and L5S1 (13 cases). Among them, 88 cases with single side and one segment, 13 cases with homolateral and two segments, 8 cases with hibateral and one segment were operated. The curative effects were followed up and estimated by recording satisfaction degrees at 1 year and 5.2 years(average) after operation. Moreover,intervertebral space height and the spinal stability of the patients were compared by imaging data before and after operation.</p><p><b>RESULTS</b>At 1 year and 5.2 years (average) after operation,the scores by JOA standard were improved from 6.40 +/- 1.68 to 13.40 +/- 1.42, 13.15 +/- 1.35 (P < 0.01) respectively;the scores by VAS standard were reduced from 7.10 +/- 1.55 to 1.90 +/- 0.84, 2.10 +/- 0.58 (P < 0.01) respectively; the excellent and good rate was 91.7% (100/109) and 89.9% (98/109) respectively; the satisfaction degree of the patients was 95.4% and 94.5% respectively. The average time before working was 1 month. The imaging data of 45 patients were complete in the study, no lumbar instability sign were found. The loss rates of intervertebral space height were 57.8% (26/45), 93.3% (42/45) respectively at 1 year and 5.2 years (average) after operation.</p><p><b>CONCLUSION</b>Discectomy with diskoscope has a good intermediate and long term clinical effects, it is a reliable method in the treatment of lumbar intervertebral disc herniation. It doesn't uncertainly cause instability of intervertebral space and root compression, though it can't avoid the loss of intervertebral space height.</p>

Observation on therapeutic effect of moxibustion on temperature-sensitive points for lumbar disc herniation / 中国针灸

<p><b>OBJECTIVE</b>To compare therapeutic effects of traditional moxibustion and moxibustion on temperature-sensitive points for lumbar disc herniation.</p><p><b>METHODS</b>One hundred and twenty cases were randomly divided into a temperature-sensitive point group and a traditional moxibustion group, 60 cases in each group. The temperature-sensitive point group was treated with moxibustion on the temperature-sensitive points in the temperature-sensitive high incidence area such as waist and lower limbs, once each day; the traditional moxibustion group was treated with warming moxibustion at Jiaji (EX-B 2), Ciliao (BL 32), Zhibian (BL 54), Huantiao (GB 30), Weizhong (BL 40), Yanglingquan (GB 34), Kunlun (BI. 60), once each day, 7 days constituting one course. The therapeutic effect and the recurrence rate were observed after one course treatment and six months later.</p><p><b>RESULTS</b>After treatment for one course, the cured-markedly effective rate was 65.00% in the temperature-sensitive point group, superior to 50.0% in the traditional moxibustion group, with a significant difference between the two groups (P < 0.05); all effective cases were followed-up for six months, the cured-markedly effective rate and the recurrence rate were 62.3% and 26.4% in the temperature-sensitive point group, and 34.2% and 46.3% in the traditional moxibustion group, the therapeutic effect of the temperature-sensitive point group being superior to the traditional moxibustion group, and the recurrence rate was lower than the traditional moxibustion group (both P < 0.05).</p><p><b>CONCLUSION</b>Moxibustion on temperature-sensitive points is a effective therapy for lumbar disc herniation, with stable therapeutic effect and low recurrence rate.</p>

Case-control study on embracing knee and rolling lumbar training for preventing and treating degenerative osteoarthritis of lumbar spine / 中国骨伤

<p><b>OBJECTIVE</b>To study therapeutic effects of embracing knee and rolling lumbar (EKRL) training on the pain and the function of lumbar of patients with degenerative osteoarthritis of lumbar spine.</p><p><b>METHODS</b>From 2006.8 to 2008.1, 150 patients with degenerative osteoarthritis of lumbar spine were randomly divided into the control group, EKRL training group and the combined group. In the control group (n=50), there were 16 females and 34 males, the average age was (58.8 +/- 10.2) years and the average course of diseases was (16.3 +/- 14.9) months. In the EKRL training group (n=50), there were 13 females and 37 males, the average age was (60.1 +/- 8.2) years and the average course of disease was (17.1 +/- 15.3) months. In the combined group (n=50), there were 15 females and 35 males, the average ages was (59.9 +/- 11.4) years and the average course of diseases was (19.8 +/- 17.2) months. The patients in three groups were treated with Meloxicam tablets, EKRL training and two above methods combination respectively. After 3 weeks treatment, the curative effect, the visual analogous scores and the ODI indexes were observed. All the patients were followed up and the duration ranged from 6 to 24 months; the changes of average ODI indexes were observed monthly.</p><p><b>RESULTS</b>After 3 weeks treatment, the therapeutic effects in three groups had obvious difference after Ridit analyses: there were significant differences between the combined group and other two groups (P<0.01), but no obvious differences existed in other two groups. Compared with before treatment, the visual analogue scale scores and the ODI indexes in three groups reduced significantly (P<0.01). After treatment, the visual analogue scale scores and the ODI indexes of the combined group had significant differences compared with those of other two groups (P<0.01), but the ODI indexes of other two groups had no obvious differences. After 6 to 24 months following-up, the monthly changes of average ODI indexes of EKRL training and combined groups had obvious differences compared with that of the control group (P<0.01).</p><p><b>CONCLUSION</b>EKRL training is a simple, no expense and effective methods for preventing and treating degenerative osteoarthritis of lumbar spine.</p>

Clinical significance of serum glutamyl transpeptidase in chronic hepatitis B / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To evaluate the relationship between changes and clinical significance of serum glutamyl transpeptidase (GGT) and the degree of liver lesions in chronic hepatitis B (CHB).</p><p><b>METHODS</b>Examinations of serum ALT, AST, GGT levels and liver biopsy were carried out and classification and staging of liver fibrosis and inflammation were performed for 70 patients with CHB. The relationship between ALT, AST, GGT and CHB was analyzed.</p><p><b>RESULTS</b>(1) ALT, AST and GGT increased with the degree of inflammation and fibrosis, but their levels declined with the degree of G4 and S4. The correlation coefficients of ALT and GGT, AST and GGT were (0.322 and 0.328, P less than 0.05). With liver-protective treatment, in the cases with mild CHB, ALT was normalized quickly but GGT remained at a lower level. While ALT declined, GGT was still at a relatively high level for moderate and severe CHB cases, among them the level of GGT fluctuated.</p><p><b>CONCLUSION</b>Serum GGT reflects the degree of liver inflammation more accurately than ALT and AST do and GGT activity can provide important evidence for clinical assessment of chronic hepatitis B.</p>