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Periarticular fracture of the shoulder is a common type of fractures in the elderly. Postoperative adverse events such as internal fixation failure, humeral head ischemic necrosis and upper limb dysfunction occur frequently, which seriously endangers the exercise and health of the elderly. Compared with the fracture with normal bone mass, the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation, so the clinical management becomes more difficult. At present, there is no targeted guideline or consensus for this type of fracture in China. In such context, experts from Youth Osteoporosis Group of Chinese Orthopedic Association, Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics, Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly ( version 2023). Nine recommendations were put forward from the aspects of diagnosis, treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder, hoping to promote the standardized, systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.
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Objective:To investigate the risk factors of bone cement leakage after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fracture (OVCF).Methods:A multi-center, large-sample, case-control study was carried out to analyze the clinical data of 2 273 OVCF patients (2 689 vertebrae) undergone PVP at four hospitals between May 2018 and October 2021, including 994 males and 1 279 females, with the age of 52-91 years [(69.1±3.1)years]. Of all, 581 patients (604 vertebrae) were allocated to leakage group and 1 692 patients (2 085 vertebrae) to no leakage group according to the occurrence of bone cement leakage. The gender, age, fracture sites, vertebral compression degree, endplate integrity of fractured vertebrae, surgical segments, surgical approaches and bone cement injection volume were recorded. Univariate analysis was used to investigate the correlation between those indicators with bone cement leakage. Multivariate Logistic regression analysis was used to identify the independent risk factors for bone cement leakage.Results:Univariate analysis showed that gender, age, fracture sites, vertebral compression degree, bone cement injection volume were related to bone cement leakage after PVP ( P<0.05 or 0.01), but no correlation was found in the endplate integrity of fractured vertebrae, surgical segments and surgical approaches (all P>0.05). Multivariate Logistic regression analysis showed that fracture sites ( OR=1.68, 95% CI 1.11-2.55, P<0.05), vertebral compression degree more than 40% ( OR=1.98, 95% CI 1.29-3.02, P<0.01), bone cement injection volume greater than or equal to 5.5 ml ( OR=1.55, 95% CI 1.07-2.26, P<0.05) were significantly associated with bone cement leakage after PVP. Conclusion:Thoracic vertebral fracture, vertebral compression degree more than 40% and bone cement injection volume greater than or equal to 5.5 ml are independent risk factors for bone cement leakage after PVP in OVCF.
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Objective:To investigate the difference of curative effect between zero-profile bridge-shaped locking cage (ROI-C) and anterior cage combined with titanium plate fixation in the treatment of two-level and three-level cervical spondylotic myelopathy.Methods:A total of 85 patients (43 males and 42 females), aged 52.3±8.0 years (range from 28 to 66 years) with bi- and three-level cervical spondylotic myelopathy who received surgical treatment from June 2017 to October 2019 were retrospectively analyzed. There were 63 cases of two levels and 22 cases of three levels. 45 cases were treated with zero-profile bridge-shaped locking cage ROI-C (ROI-C group), and 40 cases with anterior cage combined with titanium plate fixation (titanium plate group). The main observation indicators include operation time, intraoperative blood loss, cervical Cobb angle, fusion segment Cobb angle, average intervertebral height, pain visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) Score and neck disability index (NDI).Results:All of 85 patients were followed up for 16.9±2.0 months (range 12 to 22 months). The operation time of two-level ROI-C group was 110.37±8.25 min, which was shorter than 139.5±10.54 min of titanium plate group; the intraoperative blood loss was 15.74±8.10 ml, which was less than 23.71±9.70 ml of titanium plate group; the operation time of three-level ROI-C group was 130.00±5.70 min, which was shorter than 162.83±5.59 min of titanium plate group, while the difference in the intraoperative blood loss between the two groups had no statistical significance. One year after operation, Cobb angle of cervical vertebra in double and three-level ROI-C groups were 15.31°±1.55° and 15.20°±0.42°, respectively, which were largerthan 11.23°±2.03° and 9.20°±1.14° before operation; in titanium plate group, they were 15.89°±1.13° and 16.08°±1.88°, which were higher than 11.25°±2.01° and 9.00°±1.60° before operation, and the differences had statistical significance. The differences between the two groups before operation and 1 year after operation had no statistical significance. One year after operation, the VAS scores of double and three-level ROI-C groups were 1.83±0.66 points and 2.60±0.52 points, respectively, which were less than the preoperative 7.49±0.51 points and 7.60±0.52 points; the titanium plate group was 1.79±0.50 points and 2.41±0.51 points, which were less than the preoperative 7.61±0.63 points and 7.42±0.52 points, and the differences had statistical significance. There was no significant difference between the two groups before operation and 1 year after operation. One year after operation, the JOA scores of double and three-level ROI-C groups were 15.00±0.84 points and 14.70±0.95 points, respectively, which were higher than the preoperative 7.20±0.87 points and 6.60±1.27 points; the scores of titanium plate group were 15.29±0.85 points and 14.83±0.58 points, which were higher than the preoperative 6.89±1.03 points and 6.92±0.67 points, and the differences had statistical significance. The differences between the two groups had no statistical significance. The postoperative JOA improvement rate was excellent. Postoperative dysphagia occurred in 1 case (2.22%, 1/45) in ROI-C group and 8 cases (20.00%, 8/40) in titanium plate group, and the difference in the incidence rate between two groups had statistical significance ( χ2=5.32, P=0.02). Conclusion:Both ROI-C and anterior cage combined with titanium plate fixation in the treatment of double and three-level cervical spondylotic myelopathy can achieve good short-term clinical efficacy, with shorter operation time and lower incidence rate of postoperative dysphagia using ROI-C.
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Objective:To explore the short-term outcomes of a 3D printed trabecular block cage to assist posterior internal fixation for the treatment of patients with basilar invagination and atlantoaxial dislocation.Methods:Between June 2017 and February 2019, 12 patients with basilar invagination and atlantoaxial dislocation underwent atlantoaxial distraction and posterior internal fixation at Department of Orthopedics, The First Affiliated Hospital to Zhengzhou University. They were 5 males and 7 females, aged from 34 to 62 years (average, 45.6 years). 3D printed cages were inserted intraoperatively between the joints of the atlantoaxial lateral mass. The atlanto-dental interval interval (ADI), cervico-medullary angle (CMA) and distance from tip of the odontoid process to Chamberlain's line (DOCL) and the Japanese Orthopedic Association (JOA) scale were compared between preoperation and 12 months postoperation to observe the fusion of the joints of the atlantoaxial lateral mass.Results:Operation went on uneventfully in all the 12 patients. Operation time averaged 116.5 min (from 85 to 190 min), fluoroscopy frequency 9.4 times (from 6 to 21 times), and intraoperative bleeding 82.3 mL (from 50 to 210 mL). No such postoperative complications occurred as cerebrospinal leak, cerebral infarction, or breakage, displacement or loosening of implants. All patients were followed up for 18 to 42 months (mean, 26.3 months). Their preoperative JOA, ADI, CMA and DOCL [8.33±0.98, (8.66±1.64) mm, 119.63°±4.15° and (9.66±2.15) mm] were significantly improved to 14.17±1.03, (2.63±0.59) mm, 153.76°±7.88° and (2.07±0.69) mm ( P<0.05) at 12 months postoperation. Bony fusion was achieved in all the operative segments. Conclusion:In the treatment of patients with basilar invagination and atlantoaxial dislocation, a 3D-printed trabecular block cage can be used to assist posterior internal fixation to achieve satisfactory reduction and maintain the height of joint space, leading to satisfactory short-term outcomes.
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BACKGROUND@#Limited published research has examined the relationships of negative life events and coping styles with sleep quality in Chinese junior high school students. We aimed to investigate the prevalence of poor sleep quality and to clarify the role of coping styles between negative life events and sleep quality.@*METHODS@#A cross-sectional study of 3081 students was conducted in Ganzhou City, Jiangxi Province, Southeastern China. Adolescent Self-Rating Life Events Checklist, Simplified Coping Style Questionnaire, and Pittsburg Sleep Quality Index were applied to assess negative life events, coping styles, and sleep quality, respectively. Descriptive analyses, independent-samples t tests, one-way analyses of variance, Pearson correlation analyses, and structural equation modeling (SEM) were applied to analyze the data.@*RESULTS@#The prevalence of poor sleep quality was 26.7%. Negative life events (B = 0.038, P 0.05). The association between negative life events and sleep quality was mediated by negative coping styles.@*CONCLUSIONS@#Our results indicated that poor sleep quality was common in these Chinese adolescents. Negative life events and negative coping style were associated with an increased prevalence of poor sleep quality, while the positive coping style was related to a decreased prevalence of poor sleep quality. A negative coping style mediated the association between negative life events and sleep quality.
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Adolescent , Child , Humans , Adaptation, Psychological , China , Cross-Sectional Studies , Life Change Events , Psychology, Adolescent , Psychology, Child , SleepABSTRACT
BACKGROUND@#Most Chinese migrants have been faced with obstacles to getting access to local public health services. Young migrants among internal migrants make a major contribution to the economy. However, the establishment of their health records has been ignored. This research was aimed at exploring the status and associated factors of the establishment of health records among young Chinese migrants.@*METHODS@#Data were obtained from the 2017 China Migrants Dynamic Survey (CMDS). Chi-square test and binary logistic regression were performed to investigate the associated factors of the establishment of health records among young Chinese migrants.@*RESULTS@#Approximately 30.2% of young migrants had their health records established in inflow communities. Urban residence, medical insurance (insured), and lower average monthly household income were attributed to the establishment of more health records. Young migrants who were in northeast China and across provinces and immigrated for working or engaging in trade were less likely to have health records established. Young migrants who participated in social activities and public affairs activities and took type of people in touch as natives in the inflow area showed a higher possibility of establishing health records. Meanwhile, receiving health education and hearing about national basic public health services (BPHSs) were beneficial for establishing the health records of more young migrants.@*CONCLUSION@#This study showed that the health records of young migrants had a relatively low establishment rate. Sociodemographic and migration characteristics, health status, public health services, and social integration factors were all related to the health record establishment of young Chinese migrants.
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Adolescent , Adult , Female , Humans , Male , Young Adult , China , Health Records, Personal , Transients and Migrants/statistics & numerical dataABSTRACT
TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.
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With the spread of corona virus disease 2019 (COVID-19) in December 2019, the management and rehabilitation of elderly patients with hip fractures and protection of medical staff face new challenges, and need to be adjusted appropriately under this very circumstances. Hip fractures in the elderly account for more than half of osteoporotic fractures. Expert group formulate this consensus to make better decision against this epidemic and protect patients and medical staff. This consensus elaborates not only epidemic condition of COVID-19, but also general principles of medical admission, treatment and protection for both medical staff and patients, so as to provide some reference and promote the standardization of clinical diagnosis and treatment of elderly patients with hip fractures under the condition of COVID-19.
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Objective@#This study aims to explore the relationships of family functioning, general well-being, and exercise with psychological distress.Furthermore, we investigated the special roles of general well-being and exercise on the association between family functioningand psychological distress. @*Methods@#Of 769 end-stage renal disease (ESRD) patients participated in the cross-sectional study which consisted of the 12-item GeneralHealth Questionnaire (GHQ-12), the Family APGAR Scales, and the General Well-Being Schedule. The collected data were analyzedusing multiple linear regression analysis and path analysis. @*Results@#The prevalence of psychological distress was 72.3%. Family functioning, general well-being and exercise were associated factorsof psychological distress (p<0.05). The indirect effect of family functioning on psychological distress was partially mediated by generalwell-being (Effect=-0.08, 95% CI=-0.11, -0.04). In addition, the effect of family functioning on general well-being was moderated byexercise (Index=-0.092, SE=0.033, 95% CI=-0.159, -0.029). @*Conclusion@#The prevalence of psychological distress among ESRD patients was high. Family functioning, general well-being and exercisewere associated with psychological distress. Family functioning could affect psychological distress partially by affecting general wellbeing.Furthermore, exercise had a significant moderating effect on the relationship between family functioning and general well-being.Psychiatry Investig 2020;17(4):356-365
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With the spread of novel coronavirus pneumonia (NCP) in December 2019, the management and rehabilitation of elderly patients with hip fractures and protection of medical staff face new challenges, and need to be adjusted appropriately under this very circumstances. Hip fractures in the elderly account for more than half of osteoporotic fractures. Expert group formulate this consensus so as to make better decision against this epidemic and protect patients' families and medical staff. This consensus elaborates not only epidemic condition of NCP, but also general principles of medical admission, treatment and protection for both medical staff and patients, in order to provide some reference and promote the standardization of clinical diagnosis and treatment of elderly patients with hip fractures under the condition of NCP.
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Objective@#The clinical characteristics of dural arteriovenous fistula with pulsatile tinnitus were analyzed to deepen the understanding of the disease.@*Methods@#The clinical data of five patients complained of pulsatile tinnitus and diagnosed dural arteriovenous fistula in Henan People's Hospital from May 2013 to June 2018 were retrospectively analyzed, including 3 males and 2 females, aged 27-65 years.@*Results@#The main clinical symptoms of the five patients were continuous pulsatile tinnitus, accompanied/not accompanied by headache, memory decline, etc., with a course of three months to 20 years. They were diagnosed as dural arteriovenous fistula by digital subtraction angiography, and three cases of tinnitus disappeared and two cases of tinnitus were relieved after embolization.@*Conclusions@#The dural arteriovenous fistula is a rare and complicated disease. When the patient complain of the pulsatile tinnitus, the related etiology should be considered and managed properly.
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Objective@#To investigate the clinical effect of percutaneous curved vertebroplasty in the treatment of thoracolum-bar osteoporotic vertebral compression fractures (OVCFs).@*Methods@#All of 85 patients with single thoracolumbar vertebral OVCFs who met the admission criteria from January 2017 to July 2018 were divided into three groups according to the random dig-its table method. They were treated with percutaneous curved vertebroplasty, routine unipedicular PVP and routine bipedicular PVP respectively. There were 25 patients in the percutaneous curved vertebroplasty group, 6 males and 19 females; aged 56-80 years, with an average age of 70.6±9.7 years. Fracture vertebral body distribution: T10 2 cases, T11 4 cases, T12 3 cases, L1 9 cases, L2 3 cases, L3 1 case, L4 1 case and L5 2 cases. There were 32 patients in the routine unipedicular PVP group, 6 males and 26 fe-males; aged 58-75 years, with an average age of 69.5±9.3 years. Fracture vertebral body distribution: T10 2 cases, T11 4 cases, T12 5 cases, L1 11 cases, L2 6 cases, L3 1 case, L4 1 case and L5 2 cases. There were 28 patients in the routine bipedicular PVP group, 5 males and 23 females; aged 59-81 years, with an average age of 69.8±8.8 years. Fracture vertebral body distribution: T10 2 cases, T11 4 cases, T12 4 cases, L1 10 cases, L2 4 cases, L3 1 case, L4 1 case and L5 2 cases. The operation time, injected cement volume, in-traoperative blood loss were recorded and analyzed. Preoperative, postoperative 1 week and 3 months visual analogue scale scores and oswestry disability index were adopted to value the clinical improvements. Preoperative, postoperative 1 week and 3 months relative vertebral height and kyphosis correction, and the cement leakage rate were measured and analyzed.@*Results@#There was no significant difference in the data of gender, age, VAS scores, ODI and distribution of fracture vertebrae among the three groups (P>0.05), and the baseline data was comparable. The average VAS score in the percutaneous curved vertebroplasty group was 2.3±0.5 at 1 week after surgery, that of the routine unipedicular PVP group was 2.4±0.4 and that of the routine bipe-dicular PVP group was 2.4±0.4; the average ODI in the percutaneous curved vertebroplasty group was 19.8%±3.9%, that of the routine unipedicular PVP group was 20.0%±4.1% and that of the routine bipedicular PVP group was 19.9%±3.8%; they were lower than the preoperative data, which were statistically significant (P<0.001). The average relative vertebral height in the percutaneous curved vertebroplasty group was 48.99%±9.23% at 3 months after surgery, that of the routine unipedicular PVP group was 47.11%±10.12% and that of the routine bipedicular PVP group was 46.71%±11.16%; the average kyphosis cor-rection in the percutaneous curved vertebroplasty group was 6.21%±1.94%, that of the routine unipedicular PVP group was 5.22%±2.07% and that of the routine bipedicular PVP group was 5.97%±2.09%; there was 1 cement leakage case in the per-cutaneous curved vertebroplasty group; those of the routine unipedicular PVP group were 4 cases and those of the routine bipe-dicular PVP group were 6 cases; there was no significant difference among the three groups (P>0.05). Operation time 39.10±2.00 min vs 38.70±1.70 min, injected cement volume 3.60±0.11 ml vs 3.50±0.13 ml and blood loss 5.10±0.30 ml vs 5.00±0.40 ml of the percutaneous curved vertebroplasty group and the routine unipedicular PVP group were less than those of the routine bipedicular PVP group, which were statistically significant (P<0.05).@*Conclution@#Percutaneous curved vertebroplasty could achieve satisfactory clinical outcomes for OVCFs, with advantages of less operation time, less blood loss, limited X-ray expo-sure, less injected cement volume, and more balanced augmentation for stabilization of the affected vertebrae and total verte-bral column.
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Objective@#To investigate the clinical effect of surgical treatment of pituitary adenoma via neuroendoscopic-assisted transsphenoidal approach in elderly patients.@*Methods@#This was a prospective case-control study.Eighty-five patients with senile pituitary adenoma admitted to our hospital from May 2015 to February 2018 were consecutively enrolled in our study.Patients with pituitary adenoma were divided into the control group(n=42)undergoing conventional microsurgery and the observation group(n=43)receiving microsurgery via neuroendoscopic-assisted transsphenoidal approach.The effect of surgery, perioperative indexes(intraoperative blood loss, operation time, hospitalization time)and the serum level changes of prolactin(PRL), growth hormone(GH)and adrenocorticotropic hormone(ACTH)before and after surgery were recorded and compared between two groups.The incidences of complications in both groups and the dimensions of life quality(physical, cognitive, emotional, social activities)before and after surgery were calculated and assessed.@*Results@#The total effective rate was higher in the observation group(88.4%, 38/43)than in the control group(69.0%, 29/42)(P<0.05). The intraoperative blood loss, operation time and hospital days were less in the observation group than in the control group(P<0.05). No significant differences were found in serum levels of PRL, GH and ACTH between the two groups before and at 3 days after surgery(P>0.05). However, serum levels of PRL, GH and ACTH were deceased in both groups at 3 days after operation compared with before operation.The incidence of complications was lower in the observation group than in the control group(4.7% or 2/43 vs.21.4% or 9/42, P<0.05). The quality of life scores of the cognitive, role, physical, emotional and social dimensions were higher in the observation group than in the control group(P<0.01).@*Conclusions@#Neuroendoscopic-assisted transsphenoidal approach for surgical treatment of senile pituitary adenomas has less intraoperative blood loss, shorter operation time and lower complication rate, improves the endocrine hormone levels and the quality of life, and shortens the hospital stays.
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Objective To investigate the clinical effect of surgical treatment of pituitary adenoma via neuroendoscopic-assisted transsphenoidal approach in elderly patients.Methods This was a prospective case-control study.Eighty-five patients with senile pituitary adenoma admitted to our hospital from May 2015 to February 2018 were consecutively enrolled in our study.Patients with pituitary adenoma were divided into the control group(n=42)undergoing conventional microsurgery and the observation group(n=43)receiving microsurgery via neuroendoscopic-assisted transsphenoidal approach.The effect of surgery,perioperative indexes (intraoperative blood loss,operation time,hospitalization time) and the serum level changes of prolactin (PRL),growth hormone (GH) and adrenocorticotropic hormone(ACTH)before and after surgery were recorded and compared between two groups.The incidences of complications in both groups and the dimensions of life quality(physical,cognitive,emotional,social activities)before and after surgery were calculated and assessed.Results The total effective rate was higher in the observation group(88.4 ％,38/43)than in the control group (69.0 ％,29/42) (P ＜ 0.05).The intraoperative blood loss,operation time and hospital days were less in the observation group than in the control group(P＜0.05).No significant differences were found in serum levels of PRL,GH and ACTH between the two groups before and at 3 days after surgery (P＞0.05).However,serum levels of PRL,GH and ACTH were deceased in both groups at 3 days after operation compared with before operation.The incidence of complications was lower in the observation group than in the control group(4.7％ or 2/43 vs.21.4％ or 9/42,P＜0.05).The quality of life scores of the cognitive,role,physical,emotional and social dimensions were higher in the observation group than in the control group (P ＜ 0.01).Conclusions Neuroendoscopic-assisted transsphenoidal approach for surgical treatment of senile pituitary adenomas has less intraoperative blood loss,shorter operation time and lower complication rate,improves the endocrine hormone levels and the quality of life,and shortens the hospital stays.
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Objective To investigate the clinical effect of percutaneous curved vertebroplasty in the treatment of thoracolum?bar osteoporotic vertebral compression fractures (OVCFs). Methods All of 85 patients with single thoracolumbar vertebral OVCFs who met the admission criteria from January 2017 to July 2018 were divided into three groups according to the random dig?its table method. They were treated with percutaneous curved vertebroplasty, routine unipedicular PVP and routine bipedicular PVP respectively. There were 25 patients in the percutaneous curved vertebroplasty group, 6 males and 19 females; aged 56-80 years, with an average age of 70.6±9.7 years. Fracture vertebral body distribution:T10 2 cases,T11 4 cases,T12 3 cases, L1 9 cases, L2 3 cases, L3 1 case, L4 1 case and L5 2 cases. There were 32 patients in the routine unipedicular PVP group, 6 males and 26 fe? males; aged 58-75 years, with an average age of 69.5±9.3 years. Fracture vertebral body distribution: T10 2 cases, T11 4 cases, T12 5 cases, L1 11 cases, L2 6 cases, L3 1 case, L4 1 case and L5 2 cases. There were 28 patients in the routine bipedicular PVP group, 5 males and 23 females; aged 59-81 years, with an average age of 69.8±8.8 years. Fracture vertebral body distribution: T10 2 cases, T11 4 cases, T12 4 cases, L1 10 cases, L2 4 cases, L3 1 case, L4 1 case and L5 2 cases. The operation time, injected cement volume, in?traoperative blood loss were recorded and analyzed. Preoperative, postoperative 1 week and 3 months visual analogue scale scores and oswestry disability index were adopted to value the clinical improvements. Preoperative, postoperative 1 week and 3 months relative vertebral height and kyphosis correction, and the cement leakage rate were measured and analyzed. Results There was no significant difference in the data of gender, age, VAS scores, ODI and distribution of fracture vertebrae among the three groups (P>0.05), and the baseline data was comparable. The average VAS score in the percutaneous curved vertebroplasty group was 2.3±0.5 at 1 week after surgery, that of the routine unipedicular PVP group was 2.4±0.4 and that of the routine bipe?dicular PVP group was 2.4±0.4; the average ODI in the percutaneous curved vertebroplasty group was 19.8%±3.9%, that of the routine unipedicular PVP group was 20.0%±4.1% and that of the routine bipedicular PVP group was 19.9%±3.8%; they were lower than the preoperative data, which were statistically significant (P<0.001). The average relative vertebral height in the percutaneous curved vertebroplasty group was 48.99%±9.23% at 3 months after surgery, that of the routine unipedicular PVP group was 47.11%±10.12% and that of the routine bipedicular PVP group was 46.71%±11.16%; the average kyphosis cor?rection in the percutaneous curved vertebroplasty group was 6.21%±1.94%, that of the routine unipedicular PVP group was 5.22%±2.07% and that of the routine bipedicular PVP group was 5.97%±2.09%; there was 1 cement leakage case in the per?cutaneous curved vertebroplasty group; those of the routine unipedicular PVP group were 4 cases and those of the routine bipe?dicular PVP group were 6 cases; there was no significant difference among the three groups (P>0.05). Operation time 39.10± 2.00 min vs 38.70±1.70 min, injected cement volume 3.60±0.11 ml vs 3.50±0.13 ml and blood loss 5.10±0.30 ml vs 5.00±0.40 ml of the percutaneous curved vertebroplasty group and the routine unipedicular PVP group were less than those of the routine bipedicular PVP group, which were statistically significant (P<0.05). Conclution Percutaneous curved vertebroplasty could achieve satisfactory clinical outcomes for OVCFs, with advantages of less operation time, less blood loss, limited X?ray expo?sure, less injected cement volume, and more balanced augmentation for stabilization of the affected vertebrae and total verte?bral column.
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Objective To research the correlation between the level of serum brain natriuretic peptide (BNP) ,soluble vascular endothelial growth factor receptor 1 (sFlt-1) and nitric oxide (NO) and the changes of condition in preeclampsia(PE) patients.Methods Totally 89 patients with PE who had prenatal examina-tion and normal delivery in the hospital from May 2014 to January 2017 were enrolled in this study as the PE group ,and 94 healthy pregnant women who underwent normal delivery during the same period were selected as the NP group.The levels of serum BNP ,sFlt-1 and NO in PE patients with different severity and different onset stages were compared and analyzed.Results The levels of serum BNP and sFlt-1 in the PE group were significantly higher than those in the NP group ,and the level of NO was significantly lower than that in the NP group ,and the differences were statistically significant (P＜0.05).The levels of serum BNP and sFlt-1 in the severe PE group were significantly higher than those in the mild PE group ,and the level of NO was signifi-cantly lower than that in the mild PE group ,and the differences were statistically significant (P＜0.05).The levels of serum BNP and sFlt-1 in the early and late onset PE groups were significantly higher than those in the early NP group and the late NP group ,while the NO levels were significantly lower than those in the early NP group and the late NP group ,and the differences were statistically significant (P＜0.05).Conclusion On the occurrence of PE ,the levels of serum BNP and sFlt-1 in pregnant women elevated abnormally ,and the lev-el of NO decreased.The changes of serum BNP ,sFlt-1 and NO levels are closely related to the development of PE ,and can be used as a reference index to detect the changes of PE.
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Objective: The burden of noncommunicable diseases (NCDs) is increasing in China, together with economic development and social changes. The prevalence of risk factors for NCDs, such as overweight/obesity, hypertension, diabetes, and dyslipidemia, is reported to be high even among poor residents of rural areas. We aimed to investigate the prevalence of hypertension among elderly adults in rural Northeast China and the proportion with controlled hypertension among those on antihypertensive medication (hypertension control rate). We also aimed to examine the association of hypertension control with health facilities that provide treatment.Methods: We conducted a community-based cross-sectional study in six rural villages of Northeast China from February to early March, 2012. We interviewed 1593 adults aged 50–69 years and measured their blood pressure. We examined the differences in mean blood pressure between participants who obtained antihypertensive medication from village clinics and those who obtained medication from other sources, using analysis of covariance adjusted for several covariates.Results: The prevalence of hypertension among participants was as high as 63.3%, but the hypertension control rate was only 8.4%. Most villagers (98.1%) were not registered in the chronic disease treatment scheme of the public rural health insurance. The mean systolic blood pressure, adjusted for the covariates, of participants who obtained antihypertensive medication from village clinics was significantly lower than that of participants who obtained medication from township hospitals (by 16.5 mmHg) or from private pharmacies (by 7.3 mmHg).Conclusion: The prevalence of hypertension was high and the hypertension control rate low among elderly villagers during the cold season. As treatment at village clinics, which villagers can access during the cold season seems to be more effective than self-medication or treatment at distant hospitals, improving the quality of treatment in village clinics is urgently needed.
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Objective To determine the feasibility and safety of transprostatic utricle seminal vesiculoscopy in the treatment of hemospermia. Methods Totally 11 patients with hemospermia, mean age of (46.6 ± 3.5) years, ranging from 38 to 68 years, for 3 months admitted from September 2012 to August 2015 were enrolled, Their main manifestations were hemospermia. Painful ejaculation was observed in 7 patients, and perineal and testicular pain occured in 4 patients. They all underwent transprostatic utricle seminal vesiculoscopy, and then were followed up for 3 to 6 months. Results Ten patients were operated successfully, but 1 patient failed. The operation revealed that the causes of hemospermia were seminal vesiculitis in 8 cases, seminal vesiculitis accompanied with seminal calculi in 2 cases, and ejaculatory duct cyst in 1 case. Operation time was (29.2 ± 3.2) min ( ranging from 25 to 37 min) , and hospital stay was 2 d ( from 2 to 4 d). Hemospermia disappeared in 10 patients within 1 month of surgery, and hemospermia recurrence was observed in 1 patient within 6 months. The patient was treated with transprostatic utricle Holmium laser incision, then hemospermia was dispeared,Two cases of postoperative epididymitis were cured after one week of antibiotic treatment. Conclusions Seminal vesiculoscopy is a safe and effective to treat hemaospermia.
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Objective To comparatively analyze the cognition and feelings of professional self-con-cept of nurse (PSCN) between nursing students and nursing staff and and to propose recommendations for the education of nursing students. Methods Professional self-concept of nurses instrument (PSCNI) scale was used to investigate the self evaluation of nursing students and nursing staff in the aspects of nursing skills, leadership, flexibility,satisfaction degree and communication skills. SPSS 19.0 was used to analyze the total scores and scores of each aspects; F test and t test were used to analyze the difference between two groups. Results Total score for nursing students and nursing staff were (81.27±7.40) points (67.7%) and (85.00±7.96) points (70.0%), with significant differences between the two groups (P=0.003). Scores in as-pects of nurturing skills, communication, flexibility were higher in nursing staff than in nursing students, with significant differences between the two groups (P<0.05). Conclusion The cognition and feeling of nursing staff is better than nursing students in aspects of nurturing skills, communication, flexibility. Nursing teaching can correspondingly improved based on the differences between the two groups.
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[ABSTRACT]OBJECTIVETo analyze the risk factors and clinical curative effect of revision endoscopic sinus surgery.METHODSThe clinical data of the 80 patients underwent revision endoscopic sinus surgery were analyzed and the efficacy of the surgery was evaluated by the scores of the endoscopic examination, Lund-Mackay and VAS scoring system. Recovery rate and risk factors were observed and assessed. RESULTSIn 80 patients, 62 cases recovered, 11 cases improved, 7 cases were ineffective,and the total effective rate was 91.25%. Single factor analysis showed that operation frequency, follow-up compliance, history of allergic rhinitis and polyps effect on the clinical curative effect significantly (P<0.05). Multiple Logistic regression analysis showed that main risk factors affecting the curative effect were operation frequency, history of allergic rhinitis and polyps, follow-up compliance, VAS score, endoscopic examination scores, CT examination score, and nasal cavity adhesion (relative risk was between 1.4-2.8).CONCLUSIONOperation frequency, follow-up compliance, history of allergic rhinitis and polyps are important factors on curative effect of revision surgery.