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Objective:To investigate the relationship between the blood test results of seven items of thyroid function and intolerance to 14 kinds of foods in physical examination population.Methods:Total of 45 764 participants who received physical examination and accepted 14-kind food intolerance and 7-item thyroid function detection from August 2016 to September 2019 in Chinese People′s Liberation Army General Hospital were included in this study. The data were analyzed based on age, gender, body mass index, smoking and drinking status, and laboratory test indexes. Chi square test and univariate or multivariate logistic regression were applied to analyze the correlation between food intolerance and thyroid function in the physical examination population.Results:In the subjects, there were 29 361 cases (64.16%) with at least intolerance to one kind of food, and 15 011 (32.80%) were in Grade 1, 9 037 (19.75%) in grade 2 and 5 313 (11.61%) in grade 3. The positive rate of egg intolerance was the highest (34.06%), and that of beef intolerance was the lowest (1.24%). Of the participants, 11 337 (24.77%) had at least one item thyroid dysfunction, among them, the highest abnormal rate was found in thyroid stimulating hormone (TSH), followed by anti-thyroglobulin antibodies and anti-thyroid peroxidase antibodies. The proportion (26.32%) of abnormal thyroid function in the participants with at least intolerance to one kind of food was significantly higher than that (22.00%) in the participants without intolerance to the 14 kinds of foods ( χ2=105.78, P<0.001). After adjusting for other significantly related factors, the positive results of intolerance to 14 kinds of foods was still the significant influencing factor of thyroid function abnormalities ( OR=1.14, Z=5.68, 95% CI: 1.09-1.20, P<0.001). Further analysis showed that, after adjusted for age, gender, smoking and drinking status, intolerance to four kinds of foods (egg, soybean, crab and pork) were the significant influencing factors of abnormal thyroid function. Conclusions:Food intolerance is an independent risk factor of thyroid dysfunction. Among them, egg, soybean, crab and pork may be the most important food varieties should be paid more attention to.
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Objective:To investigate the clinical effect of small incision in the sinus tarsal combined with internal fixation with hollow nails or small plates in the treatment of Sanders type II and III calcaneal fractures.Methods:A retrospective analysis of the relevant data of 50 patients with closed calcaneal fractures (sander II, III) were admitted and followed up from September 2015 to April 2017. According to different surgical methods, they were divided into two groups. Those who used a small incision of the sinus tarsal combined with hollow nail or small plate internal fixation were the minimally invasive group; those who used the traditional lateral "L" approach combined with the traditional plate internal fixation were the open group. There were 30 cases in the minimally invasive group, 20 males and 10 females; age 44.53±13.74 years (19 to 78 years); 20 cases in the open group, 13 males and 7 females; age 45.35±12.93 years (19 to 70 years old). The two groups of patients were treated with different methods for surgical treatment. During the operation, the calcaneal varus was corrected and the length, width, and height of the calcaneus were restored, but the fracture end was fixed in different ways. X-ray and CT examinations were performed before and after the operation to evaluate the type of fracture, reduction and fracture healing, the Bohler angle and Gissane angle at the last follow-up were measured, and postoperative complications were recorded. The Maryland foot scoring system was used to evaluate the clinical efficacy.Results:The difference in general information between the two groups of patients was not statistically significant and comparable. Patients in both groups were followed up for 16 months to 36 months, with an average of 21 months. In the minimally invasive group, 7 cases received allogeneic bone grafts, 17 cases were fixed with microplates, and 13 cases were fixed with hollow lag screws; 5 cases in the open group received allogeneic bone grafts, all of which were fixed with conventional lateral calcaneal plates. The intraoperative blood loss during operation in the minimally invasive group was 48.23±5.56 min, the open group was 54.25±5.09 min; the minimally invasive group was 53.10±8.5 ml, and the open group was 61.75±7.13 ml. The differences were statistically significant ( t=3.75 and 3.87, P<0.01). The fracture healing time of the minimally invasive group was 9.6±1.52 weeks, and that of the open group was (11.05±2.33) weeks. The difference between the two groups was statistically significant ( t=2.67, P<0.05). According to the Maryland score at the last follow-up, the excellent and good rate was 80.00% in the minimally invasive group and 50% in the open group. Postoperative imaging showed that the articular surface of the two groups after calcaneal surgery was collapsed and reset, the height, width and length of the calcaneus were restored, and the axis of the calcaneus was corrected. The Gissane angle and Bohler angle were significantly different from those before the operation (both P<0.001) , while Bohler angle in minimally invasive group (15.50°±4.18° vs 31.03°±3.35°, t=15.88), Gissane angle in minimally invasive group (101.87°±9.94° vs 129.17°±4.85°, t=13.52); Bohler angle in open group (15.00°±4.22° vs 30.75°±3.39°, t=13.02), and Gissane angle (104.75°±11.02° vs 128.6°±4.56°, t=8.95). There was no significant difference in the Gissane angle ( t=0.414, P=0.68) and Bohler angle ( t=0.292, P=0.77) between the two groups of patients. In the minimally invasive group, there was 1 case of traumatic arthritis and 1 case of superficial skin border infection, with a complication rate of 6.67%. In the open group, there was 2 cases of skin border necrosis secondary to deep infection, 3 cases of superficial skin border, 2 cases of infection and traumatic arthritis, and the complication rate was 35%. The difference in the overall complication rate between the two groups was statistically significant ( P=0.021). Conclusion:The treatment of calcaneal fractures with sinus tarsal incision plate or hollow screw internal fixation has the advantages of less trauma, reduction under direct vision, reliable reduction and fixation, and low complications. It is suitable for Sanders type II and III calcaneal fractures.
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Objective To explore the surgical efficacy of trans-syndesmotic ankle fracture dislocation (the "Logsplitter" injury) plus the Tillaux-Chaput fracture / the Wagstaffe-Lefort fracture and the Volkmann fracture without tibiofibular joint screwing.Methods Between January 2015 and December 2018,16 adult patients with the "Logsplitter" injury plus avulsion fractures were treated by open reduction and internal fixation at Department of Orthopaedics,The Sixth Affiliated Hospital,Xinjiang Medical University.They were 11 males and 5 females with an average age of 36.4 years (range,from 27 to 56 years).There were 2 open fractures (one type Ⅱ and one type ⅢA by the Anderson-Gustilo classification) and 14 closed ones;all fractures were type 44-C by the AO/OTA classification;according to the Lauge-Hansen classification,there were 9 cases of pronation-abduction rotation,3 cases of pronation-external rotation and 4 cases of supination-external rotation.The fibular fractures were treated through a single lateral approach followed by plate fixation.The Volkmann fractures were fixed with screws and the Tillaux-Chaput fractures / the Wagstaffe-Lefort fractures with screws or Kirschner wires.The ankle functions were assessed postoperatively using the ankle-hindfoot rating system of the American Orthopaedic Foot and Ankle Society (AOFAS),and the dysfunction index and bother index of Short Musculoskeletal Function Assessment (SMFA).Results All the patients were followed up for 8 to 27 months (average,21.3 months).X-ray films showed complete fracture healing in all cases after 12 to 18 weeks postoperatively (mean,14.8 weeks).At the last follow up,13 patients walked normally and 2 with mild discomfort.Their AOFAS scores averaged 96.3 (range,from 86 to 100),giving 12 excellent,3 good and one poor cases;their SMFA dysfunction index was 15.9 (range,from 8 to 17)and SMFA bother index 6.5 (range,from 3 to 9)at the last follow-up.Conclusions In the treatment of trans-syndesmotic ankle fracture dislocation — the "Logsplitter" injury,open reduction and internal fixation of the Tillaux-Chaput fracture / the Wagstaffe-Lefort fracture and the Volkmann fracture to reconstruct the lower tibiofibular horizontal stable "ring",without tibiofibular joint screwing,can obtain satisfactory clinical results.
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<p><b>OBJECTIVE</b>To compare the clinical efficacy differences between intradermal needling combined with and alone on ankle sprain sequelae.</p><p><b>METHODS</b>Ninety patients with chronic ankle sprain were randomly divided into an observation group and a control group, 45 cases in each group. The patients in the control group were treated with conventional . The patients in the observation group were treated with conventional , followed by intradermal needling at point (the most painful tendons node), Shenmai (BL 62)/Zhaohai (KI 6), Jiexi (ST 41)/Zhongfeng (LR 4), Qiuxu (GB 40)/Shangqiu (SP 5) for 24 to 48 hours per treatment; acupoint selection was based on the different side of ankle sprain, and 5 acupoints were selected per treatment, including 2 painful points. The treatment was given twice per week, and totally 8 treatments were given within 4 weeks. The follow-up visit was 12 months. The pain of tendon joints was evaluated by visual analogue scale (VAS); the patient number of severity of ankle pain during walking and running as well as the occurrence and frequency of ankle pain during rest in follow-up visit in the two groups were observed; the satisfaction survey was conducted in the observation group.</p><p><b>RESULTS</b>Compared before treatment, VAS of tendon joints, the patient number of severity of ankle pain during walking and running were improved after treatment in the two groups (all <0.05), and patient number of the severity of ankle pain during running in the observation group was superior to that in the control group (<0.05). During follow-up visit, compare with the control group, the occurrence and frequency of ankle pain during rest in the observation group was significantly improved (both <0.05); the satisfaction in the observation group was significant.</p><p><b>CONCLUSION</b>The intradermal needling combined with could improve the tenderness of tendon joints and pain during walking and running in patients with ankle sprain sequelae; compared with alone, it could reduce the occurrence of ankle pain during rest, which is safe and reliable.</p>
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Objective To compare the effects of external fixator and open reduction and internal fixation on unstable distal radius fractures and the influence on pain score.Methods From March 2012 to March 2016, 100 cases of unstable distal radius fractures admitted in Pinggu Hospital Affiliated to Capital Medical University were selected in this research.According to different treatment ,the patients were divided into external fixed group (n＝50) and internal fixation group (n＝50).The external fixation group was treated with external fixator,and the internal fixation group was treated by open reduction and plate fixation.The clinical efficacy of the two groups and their effect on pain score were compared.Results At 3 months,12 months after operation,the articular surface steps in the internal fixa-tion group were (2.35 ±0.42)mm and (0.93 ±0.46)mm,respectively,which were significantly lower than those of the external fixation group [(2.99 ±0.38)mm,(1.41 ±0.57)mm],and the differences were statistically significant (t＝7.990,4.634,P＝0.000,0.000).The palmar inclination in the internal fixation group were (12.66 ±1.40)° and (13.32 ±1.74)°,respectively,which were significantly higher than those of the external fixation group [(9.66 ± 1.87)°,(11.35 ±1.94)°],and the differences were statistically significant (t＝9.081,5.345,P＝0.000,0.000). The ulnar deviation angle in the internal fixation group were (23.89 ±1.67)°and (24.81 ±2.02)°,respectively, which were significantly higher than those of the external fixation group [(21.59 ±1.94)°,(22.91 ±2.32)°],and the differences were statistically significant (t＝6.353,4.367,P＝0.000,0.000).The radial height in the internal fixation group were (10.23 ±0.38)mm,(11.45 ±0.42)mm,respectively,which were significantly higher than those of the external fixation group [(9.77 ±0.36)mm,(10.89 ±0.43)mm],and the differences were statistically significant (t＝6.214,6.588,P＝0.000,0.000).The excellent and good rate of wrist function recovery in the internal fixation group and the external fixation group was 82%and 74%,respectively.There was no statistically significant difference between the two groups (χ2＝0.932,P＝0.334).At 1 day,3 days after operation,the VAS scores of the external fixation group were (4.35 ±0.35)points and (2.10 ±0.46)points,respectively,which were lower than those of the internal fixation group [(5.46 ±0.71)points,(3.12 ±0.56)points],the differences between the two groups were statistically significant (t＝9.860,9.952,P＝0.000,0.000).No fracture nonunion occurred in the two groups.The clinical healing time of the external fixation group was (9.10 ±1.13) weeks,which was significantly shorter than that of the internal fixation group [(10.85 ±1.77) weeks],and there was statistically significant difference between the two groups (t＝5.893,P＝0.000).Conclusion The reduction effect of open reduction and plate fixation is better than external fixator,external fixator can effectively relieve postoperative pain and accelerate fracture healing .It is suggested that individualized treatment should be selected according to the fracture type and specific circumstances .
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Purpose To perform a Meta-analysis on papers involving the topic of preoperative grading of brain gliomas by ASL,and to evaluate the value of arterial spin labeling (ASL) in predicting high/low-grade gliomas.Materials and Methods Related English and Chinese papers published on PubMed,Cochrane library,Web of Science,CBM,China National Knowledge Internet (CNKI) and Wanfang database (January 1992-October 2016) were searched.Relevant data and parameters of the satisfactory articles were extracted followed by a Meta-analysis using RevMan 5.3,Meta-Disc 1.4 and Stata 12 software.Results A total of 11 papers were included in this study.The diagnostic data consisted of three groups of normalized perfusion parameters:normalized maximal tumor blood flow/normal white matter,normalized maximal tumor blood flow/normal gray matter and normalized maximal tumor blood flow/normal hemisphere Heterogeneity of all the three groups was nonexistent.Their diagnostic sensitivity was 0.87 (95％ CI 0.82-0.92),0.88 (95％ CI 0.79-0.94) and 0.95 (95％ CI 0.89-0.98),respectively;the specificity was 0.89 (95％ CI 0.83-0.94),0.90 (95％ CI 0.79-0.96) and 0.92 (95％ CI 0.81-0.97),respectively.The corresponding AUC of summarized receiver operating characteristic curve was 0.9418,0.9443 and 0.9468,respectively.Conclusion The normalization parametersnormalized maximal tumor blood flow/normal white matter and normalized maximal tumor blood flow/ normal gray matter determined by ASL technique is relatively accurate in predicting high/ low-grade gliomas.However,tendency towards publication bias occurs in articles of the normalized maximal tumor blood flow/normal hemisphere group,and hence its diagnostic value still needs further verification.
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Objective To study the diagnostic value of spectral CT in atypical tuberculosis ball and lung cancer.Methods 45 cases of pulmonary nodule or mass received unenhanced and two phase enhanced scan in gemstone spectral imaging mode,and all pulmonary nodule or mass were confirmed by pathology.Selecting unenhanced,arterial phase and venous phases of spectrum image,atypical tuberculosis ball group and lung cancer group were analyzed.Normalized iodine concentration (NIC), the spectral curve slope (λHU),CT value of unenhanced and two phase enhanced spectrum image were measured and calculated.Two independent samples t-test was used for the statistic analysis of each spectrum parameters between the two groups.The receiver operating characteristic (ROC) curve was obtained for comparing the sensitivity and specificity of each spectral parameter.Results Among the 45 patients,11 were atypical tuberculosis ball, and 34 were lung cancer.Comparison NIC,two phase enhanced λHU and the net enhanced CT values of 70 keV monoenergetic image of the two groups, lung cancer group was higher than atypical tuberculosis ball group,and the difference was statistically significant(P0.05).When the NIC diagnostic threshold was 0.105, the maximum Youden index (0.733), the area under the ROC curve was 0.89, and sensitivity and specificity was 82.4% and 90.9%, respectively.Conclusion The quantitative parameters of spectral CT is helpful in the diagnosis of atypical tuberculosis ball and lung cancer,especially the NIC with high value.
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The coordination and collaboration of many links are required to achieve the successful development of a high-quality clinical randomized controlled trial, in which, the compliance of the researchers affects the ultimate results and quality of the study since it is responsible for the safety and benefits of subjects in the trials and study quality. Focusing on the researchers' compliance, it is believed that the improvements in the researchers' compliance are very significant in the implementation of study scheme. At present, commonly, the researchers are of the low compliance, manifest as failure to obey the study scheme (such as inclusive criteria, enrollment sequence), failure to obey the rules of operation and data collection, failure to store the original documents but to modify the data, failure to report timely adverse events, etc. In view of clinical research monitors, the reasons on the low compliance are analyzed and the solutions are proposed.
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Objective:To investigate the changes of circulating tumor cells in locally advanced esophageal squamous cell carcinoma pa-tients treated with concurrent chemoradiotherapy. The effect of these alterations on the patients’prognosis was also analyzed. Meth-ods:Circulating tumor cells were detected by immunomagnetic enrichment and fluorescence in 48 cases of locally advanced esopha-geal carcinoma patients treated with concurrent chemoradiotherapy. The dynamic changes of circulating tumor cells were compared between pre-and post-chemoradiotherapy. Moreover, the association of these changes with the clinical characteristics and two-year survival rate were analyzed. Results:The positive rate of circulating tumor cells was closely associated with the T stage, lymph node metastasis, and clinical stage (P<0.05), and the positive rates in pre-and post-chemoradiotherapy were 52.1%(25/48) and 20.8%(10/48), respectively. The difference was statistically significant (P<0.05). Kaplan-Meier analysis showed that the positive rate of circulating tumor cells predicted an adverse two-year survival rate in both pre-and post-chemoradiotherapy (P<0.05). Cox regression analysis showed that the clinical stage and circulating tumor cells after concurrent chemoradiotherapy were independent prognostic factors in the patients with esophageal carcinoma. Conclusion:Circulating tumor cells can reflect the disease progression in patients with locally advanced esophageal cancer. These cells can also predict the prognosis of esophageal cancer patients treated with concurrent chemo-radiotherapy.
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<p><b>OBJECTIVE</b>To evaluate the preventative efficacy of preoperative electroacupuncture(EA) for gastrointestinal dysfunction after vascular surgery.</p><p><b>METHODS</b>Sixty patients with the same general anesthesia before vascular surgery were randomly assigned to an observation group and a control group,30 cases in each one. In the observation group,acupuncture was used at bilateral Neiguan(PC 6),Zusanli(ST 36) and Shangjuxu(ST 37) in the forenoon and afternoon one day before surgery,with EA(continuous wave,15 Hz) at Zusanli(ST 36) and Shangjuxu(ST 37) for 20 min. The abdominal distension rate and degree as well as the length of stay in hospital after surgery were recorded.</p><p><b>RESULTS</b>There was no statistic difference about the rate of abdominal distension between the two groups[16.7%(5/30) vs 36.7%(11/30),>0.05)],but it was lighter in the observation group 72 hours after surgery(<0.05). The length of stay in hospital in the observation group was shorter than that in the control group[(5.33±1.30) d vs (7.33±1.71) d,<0.05].</p><p><b>CONCLUSIONS</b>Acupuncture at Neiguan(PC 6),Zusanli(ST 36) and Shangjuxu(ST 37) one day before surgery can improve gastrointestinal function after vascular surgery with general anesthesia,and it has some efficacy as to shorting the length of stay in hospital.</p>
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<p><b>OBJECTIVE</b>To observe the efficacy of preventing constipation by electroacupuncture intervention in ischemic stroke patients at acute stage.</p><p><b>METHODS</b>Three hundred and forty ischemic stroke patients who matched the inclusive criteria were randomly divided into an electroacupuncture (EA) group and a routine treatment group, 170 cases in each one. In the EA group, based on routine western treatment, rehabilitation training and common acupuncture, Tianshu (ST 25) and Zusanli (ST 36) were selected and connected to SDZ-V Hwato brand electric acupuncture apparatus respectively, given stimulation of dense-disperse wave (10 Hz/50 Hz) with electric current of 0.1 to 1.0 mA, once every day and 5 times a week in the first 2 weeks, 2 times a week in the latter 2 weeks. In the routine treatment group, only basic treatment was applied. In the two groups, the course of treatment was 4 weeks and 8 weeks' follow-up was required after treatment. The actual numbers who independently defecated less than 3 times a week after 1 to 4 weeks' treatment and in the 4th and the 8th weeks' follow-up and condition taking laxative medicines during the 12 weeks in the two groups were observed and compared.</p><p><b>RESULTS</b>Compared on the numbers of constipation cases after 1 to 4 weeks' treatment, those in the EA group were all less than those in the routine treatment group [24.7% (42/170) vs. 36.5%(62/170), 18.8% (32/170) vs. 30.6% (52/170), 10.5% (17/162) vs. 27.5% (44/160), 9.3% (15/162) vs. 19.4% (31/160),P<0.05, P<0.001]. In the 4th and the 8th weeks' follow-up, numbers in the EA group were still less than those in the routine treatment group [9.0% (14/156) vs. 18.1% (28/155), 7.7% (12/155) vs. 16.9 (26/154) both P<0.05)]. During the 12 weeks, the number of cases who took laxative medicines in the EA group was less than that in the routine treatment group [21.2% (36/170) vs. 34.7% (59/170), P<0.05].</p><p><b>CONCLUSION</b>There is clinical significance to electroacupuncture at Tian-shui (ST 25) and Zusanli (ST 36) coibined with basic comprehensive treatment for preventing and treating constipation symptom in ischemic stroke acute stage.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Acupuncture Points , Constipation , Therapeutics , Defecation , Electroacupuncture , StrokeABSTRACT
BACKGROUND:Spinal canal decompression reduction fixation combined with bone graft fusion has been extensively applied in the clinic. Bilateral pedicle screw assisted interbody fusion and unilateral pedicle screw assisted interbody fusion are main methods to treat degenerative lumbar spinal stenosis and lumbar spondylolisthesis. OBJECTIVE:To compare early clinical therapeutic effects of bilateral and unilateral pedicle screw assisted interbody fusion in elderly patients with spinal stenosis and degenerative spondylolisthesis. METHODS:A total of 60 elderly patients with spinal stenosis with degenerative lumbar spondylolisthesis were selected, including 37 males and 23 females, at the age of 60 to 78 years old. They were divided into two groups, and subjected to decompression of spinal canal. In the treatment group (n=30), patients received unilateral pedicle screw assisted interbody fusion. In the control group (n=30), patients received bilateral pedicle screw assisted interbody fusion. After treatment, they were folowed up for 1 year. The recovery of joint function was assessed using Japanese Orthopaedic Association scores in both groups. Simultaneously, complications were recorded. RESULTS AND CONCLUSION:Japanese Orthopaedic Association scores were 25.7±1.9 and 25.8±1.8 in the treatment and control groups, respectively, and no significant difference was found between groups. In the treatment group, three cases affected lower limb numbness and two cases suffered from dural tear, with the incidence of complication of 17%. In the control group, three cases affected lower limb numbness and three cases suffered from dural tear, with the incidence of complication of 20%; no significant difference was detected between the two groups. No adverse reaction related to bone graft was found in the two groups. These results confirm that bilateral or unilateral pedicle screw assisted interbody fusion in treatment of degenerative lumbar spondylolisthesis with spinal stenosis obtained good therapeutic effects.
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BACKGROUND:Conventional cross-segment pedicle screw fixation wil cause some complications such as kyphosis and loss of corrective angle. Fixation of pedicle screw placement of the injured vertebral body improves the disadvantages of conventional posterior screw placement, and obtains ideal outcomes. OBJECTIVE: To investigate the clinical application value of pedicle screw placement combined with filer for lumbar vertebra fracture. METHODS: Clinical data of patients with pedicle screw placement combined with filer for lumbar vertebra fracture were retrospectively analyzed. They were repaired with pedicle screw placement combined with bone graft as wel as pedicle screw placement combined with bone cement. The ratio of anterior border to posterior border of the injured vertebral body after surgery and changes in Cobb angle were observed. Patients were folowed up and results were compared. RESULTS AND CONCLUSION: Pedicle screw placement combined with filer has many advantages, and obtained good outcomes in the treatment of lumbar vertebral fracture. However, the extensive application has some problems and disputes. Clinical physicians should pay more attention on choice of surgical indications, prevention and treatment of perioperative and long-term complications and postoperative treatment of osteoporosis. The pedicle screw fixation combined with calcium phosphate bone cement has a broad prospect, can maintain the effect of spine reduction, and is worth to spread in the clinical treatment of lumbar fractures.
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BACKGROUND:Traumatic or iatrogenic dural defects can cause persistent cerebrospinal fluid leakage, even progressing to life-threatening purulent meningitis. In patients with meningitis combined with cerebrospinal fluid leakage, most antibiotics are unable to enter the cerebrospinal fluid, as the cerebrospinal fluid is a good medium for bacteria and there is the presence of blood-brain barrier. So meningitis presents with acute onset, rapid development and infection difficult to control. OBJECTIVE:To evaluate the outcome of continuous lumbar subarachnoid drainage plus intrathecal administration of antibiotics for postoperative cerebrospinal fluid leakage combined with meningitis after biomaterial repair of dural defects. METHODS: A retrospective study was carried out to review the 12 cases of cerebrospinal fluid leakage combined with meningitis among 126 of 2 266 cases who developed cerebrospinal fluid leakage (5.56%) undergoing spinal surgery from June 2008 to June 2013. During the operation, dural defects were directly sutured or repaired with autologous fascial sheet. Al cases underwent thorough debridement and intravenous injection of sensitive antibiotics folowed by continuous lumbar drainage and intrathecal administration of sensitive antibiotics (usualy vancomycin), and then the incision was closed at stage I. RESULTS AND CONCLUSION:The cerebrospinal fluid leakage was found in the 12 cases at 24-72 hours after surgery, averagely 48 hours; the infection was found at 812 days days after surgery, averagely 9.5 days. Headache and fever were significantly relieved at the 2nd day of intrathecal administration of antibiotics, and intracranial infection disappeared at 7-14 days after continuous lumbar drainage. Biochemical test of the cerebrospinal fluid and routine examination were done thrice, and the results were al normal. No bacterial growth was found in bacterial culture test, and the drainage tube was removed. There was no intraspinal infection, intracranial hypotension headache and hernia caused by the drainage tube. These findings indicate that autologous fascia repair combined with continuous lumbar subarachnoid drainage plus intrathecal administration of antibiotics is an effective method in the treatment of cerebrospinal fluid leakage with meningitis.
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Objective To investigate the feasibility of double low scanning technique using the gem spectrum CT coronary artery angiography among the patients at low heart rate≤ 65 beats per minute.Methods This prospective study was approved by the institutional re-view board with patient informed consent.Ninty patients (heart rate≤65 beats per minute)were randomly devided into 3 groups.Group A un-derwent spectral CCTA with iodixanol (Visipaque,270mg/mL)and low scanning technique,Group B conventional CCTA with iohexol (Omnipaque,370 mg/mL)and Group C conventional CCTA with iodixanol (Visipaque,270 mg/mL),Routine scan mode was used in Group B and Group C.Prospective ECG gating mode was used in all groups.120kVp polychromatic images with FBP algorithm (Group B and Group C)were reconstructed for conventional CCTA,60 keV monochromatic images with FBP algorithm (Group A) or with a fixed blending level (40%)of ASiR (Group A1 )were reconstructed for spectral CCTA.Compared the image quality of four groups and ED in three groups.Results The difference was ststistically significant between four groups with the CT value,im-age noise,SNR and CNR of coronary (each P<0.001.Group A1 has the highest SNR and CNR.Group C has the lowest image noise.There were no significant difference of coronary score between group A1 and group B(χ2=0.01,P=1.000)).There was significant difference of coronary score between group A and group B (χ2=22.428,P<0.001),group B and group C (χ2=39.005,P<0.001), group A1 and group A (χ2=21.854,P<0.001).Effective radiation dose in the group A(ED2.60±0.26 mSv)was lower than that of group B (ED3.02±0.36 mSv)(t=3.738,P=0.001)and group C (ED3.11±0.23)(t=3.725,P=0.001).Conclusion Double low scan-ning technique using the gem spectrum CT coronary artery angiography with 40% blending level of ASiR is able to provide better im-age quality than using conventional CCTA and to reduce the effective radiation dose and contrast dose.
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<p><b>OBJECTIVE</b>To verify the clinical efficacy of acupuncture and moxibustion on depressive states of stroke patients' spouses.</p><p><b>METHODS</b>Forty-four subjects who were stroke patients' spouses and according with inclusive criteria with mild or moderate depressive states were randomly divided into an acupuncture-moxibustion group and a blank control group, 22 cases in each group. In the acupuncture-moxibustion group, acupuncture was applied at Baihui (GV 20), Shenting (GV 24), Sishencong (EX-HN 1), Hegu (LI 4), Zusanli (ST 36) and Taichong (LR 3), and suspended moxibustion was used at Shenque (CV 8), Guanyuan (CV 4) and Zhongwan (CV 12). The treatment was given twice a week for continuous 8 weeks. In the blank control group, neither acupuncture nor moxibustion treatment was given, and the patients were only treated with health and psychological guidance. Before treatment and after 8-week treatment, scores of self-rating depression scale (SDS) and numbers of insomnia severity grade were observed.</p><p><b>RESULTS</b>In the two groups, the scores of SDS were both reduced than those before treatment (both P<0.05), and the decrease in the acupuncture-moxibustion group was more obvious (P<0.05). After treatment, the number of insomnia severity grade in the acupuncture-moxibustion group was improved than that before treatment (P<0.001), and the improvement was evidently superior to that in the blank control group (P<0.05). The numbers of insomnia severity grade of the blank control group before and after treatment had no statistic significance (P>0.05).</p><p><b>CONCLUSION</b>The acupuncture and moxibustion intervention plan has clinical treatment significance on the improvement of mild and moderate depressive states for the stroke patients' primary caregivers who are the patients' spouses.</p>
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Aged , Female , Humans , Male , Middle Aged , Depression , Therapeutics , Moxibustion , Spouses , Psychology , Stroke , PsychologyABSTRACT
BACKGROUND:Conventional dynamic hip screw or artificial joint replacement can be used to treat unstable intertrochanteric fracture in aged patients. It remains unclear whether we should select one-stage replacement or remedial joint replacement after failture, and there is no unified standard globaly. OBJECTIVE: To observe the outcomes and prognosis of one-stage artificial joint replacement for unstable intertrochanteric fracture in aged patients. METHODS:From April 2008 to October 2011, 21 patients with unstable intertrochanteric fracture in aged patients were repaired with one-stage artificial joint replacement at the Second Department of Orthopedics, Changji Prefecture People’s Hospital. Among 21 patients, 1 patient previously combined with avascular necrosis of the femoral head and traumatic arthritis received biological artificial total hip replacement. Three cases were subjected to standard bone cement bipolar artificial femoral head replacement. 17 cases underwent biological bipolar artificial femoral head prosthesis replacement. Al artificial joint, internal fixation material and accessory joint replacement surgical instruments were purchased outside China. Al patients were folowed up regularly. Hip joint function was assessed by Harris hip score. RESULTS AND CONCLUSION: Al operations were completed by the same group of physicians. Operation time was 30-60 minutes, averagely 42 minutes. Incision length was 8 to 15 cm, averagely 11 cm. Average intraoperative blood loss was 50-300 mL, averagely 150 mL. The number of transfusion cases was 13. 1.5 U blood was transfused averagely in each patient during hospital stay. One 76-year-old patient combined with hypertension, coronary heart disease and diabetes suffered from sudden death due to acute myocardial infarction at 9 days after replacement. B ultrasound revealed venous thrombosis of calf muscle of double lower extremities at 3 days after replacement. No complications such as prosthetic loosening, sinking, infections and thrombosis were detected. Except 1 case died, the other 20 cases received folow-up for 6-49 months. Harris hip score was 73±4 before discharge and 82±6 during last folow-up. These data confirm that effects of one-stage artificial joint replacement for unstable intertrochanteric fracture in aged patients are affirmative, but the number of case is stil less, and deserves further investigations. We suggest that in patients with conformed indication, one-stage artificial joint replacement can be the first choice.
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Objective To evaluate the efficacy of siege scheme of TCM for acute cerebral infarction bowel and visceral strike (block pattern). Methods Totally 110 patients were randomly divided into TCM siege scheme group (55 cases) and control group (55 cases) by randomized parallel controlled study with foresight and multicenter. The control group was treated with the standardized treatment, and TCM siege scheme group was treated with TCM siege scheme, including mild hypothermia TCM pillow therapy, TCM rectal enema, and other multiple treatments based on the standardized treatment. The Glasgow Coma Scale (GCS), the time of pulling out urine tube and nasal feeding tube, and the number of tracheotomy caused by illness changes of the two groups were compared. Results The baseline data of two groups have good comparability (P>0.05). On 10, 15 d of treatment, the number of lucid people in the TCM siege scheme group was significantly more than that in the control group (P<0.05). Compared with the control group, treatment group had less number of tracheotomy, and shorter time of success pulling out urine tube and nasogastric feeding tube (P<0.05). Conclusion TCM siege scheme can improve the consciousness of ischemic stroke in patients with acute cerebral infarction bowel and visceral strike, reduce complications, shows shorter successful pull urine tube and nasogastric feeding, and provides guarantee conditions for further rehabilitation treatment.
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<p><b>OBJECTIVE</b>To compare the clinical effective differences between acupuncture-moxibustion and Chinese herbs for functional dyspepsia with emotional disorder.</p><p><b>METHODS</b>Eighty patients were randomly divided into an observation group and a control group, 40 cases in each one. In the observation group, based on the basic treatment Zusanli (ST 36), Yinlingquan (SP 9), Zhongwan (CV 12), Danzhong (CV 17), Neiguan (PC 6), Taichong (LR 3), Ganshu (BL 18), Geshu (BL 17) and Danshu (BL 19) were selected once every day or every other day. The treatment was given 14 times. In the control group, based on the basic treatment individual therapy of Chinese herbs according to syndrome differentiation was applied,one dose a day. Patients were treated for 4 weeks in the two groups. The scores of self-rating depression scale (SDS), the main symptoms and satisfied degree by self-rating for treatment were observed before and after 4-week treatment in the two groups. Also, the rate and the average time of return visit were compared in 6 months after treatment. Results After treatment, the SDS scores and the main symptoms scores were all improved compared with those before treatment in the two groups (all P< 0. 05). After 4-week treatment, the improvement of the SDS score in the observation group was better than that in the control group (48. 9±8. 5 vs 53. 1±8. 0, P<0. 05). After 1-week treatment and 4-week treatment, the improvements of the main symptoms in the observation group were superior to those in the control group (2. 7 ± 1. 0 vs 3. 3±0. 9, 1. 5±0. 9 vs 2. 3±1. 1, both P<0. 05), and the satisfied degree scores by self-rating were better than those in the control group (3. 0±1. 1 vs 3. 8±1. 3, 2. 0±1. 4 vs 2. 9±1. 5, both P<0. 05). In 6 months after treatment,the return visit rate in the observation group was 42. 5% (17/40), and it was lower than 70. 0% (28/40) in the control group (P<0. 05). The average time of return visit in the observation group was less than that in the control group (1. 0±0.8 vs 1. 9±0. 7, P<0. 05).</p><p><b>CONCLUSION</b>The effect of acupuncture-moxibustion or functional dyspepsia with emotional disorder is better than that of Chinese medicine.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Acupuncture Points , Acupuncture Therapy , Dyspepsia , Psychology , Therapeutics , Moxibustion , Treatment OutcomeABSTRACT
BACKGROUND:Autologous peroneus brevis and alogeneic tendon are often used for reconstruction of lateral colateral ligament of the ankle joint, but these two kinds of materials have different histological and biomechanical properties. OBJECTIVE:To compare the clinical effects of autologous peroneus brevis and alogeneic tendon to reconstruct lateral colateral ligament of the ankle joint. METHODS: Sixty-six patients with chronic external ankle instability caused by old injury to lateral colateral ligament of the ankle joint were enroled, aged 15-63 years. The 34 of 66 patients underwent lateral ligament reconstruction using autologous peroneus brevis and the rest 32 patients received lateral ligament reconstruction using alogeneic tendon. After reconstruction, reaction time of the peroneous brevis, talar tilt angle and anterior talar translation, visual analog scale score and the American Orthopaedic Foot and Ankle Society (AOFAS) score were compared between the two groups. RESULTS AND CONCLUSION:At the last folow-up, the visual analog scale score, tilt angle and anterior talar translation were lowered in the two groups compared with the previous (P < 0.05), and the AOFAS scores were increased significantly in the two groups (P < 0.05); the reaction time of the peroneous brevis was increased inthe autologous peroneus brevis group (P < 0.05) and decreased in the alogeneic tendon group (P < 0.05); the above-mentioned indexes had no difference between the two groups. These findings indicate that autologous peroneus brevis and alogeneic tendon have similar effects on the lateral ligament reconstruction in terms of postoperative ankle function, stability and activity levels, but the alogeneic tendon shows advantages on less trauma and shorter operation time.