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Objective:To study the effect of cardiac rehabilitation program on recovery of patients after small incision aortic valve replacement.Methods:600 patients who underwent small incision aortic valve replacement in our hospital from January 2015 to January 2020 were retrospectively collected and divided into Cardiac rehabilitation group(CR) and control group by propensity matching analysis. Clinical data of CR group and control group were collected 6 months and 12 months after the beginning of Cardiac rehabilitation program. The primary outcome measures were the peak oxygen uptake(VO 2 Peak) of cardiopulmonary function test and the number of patients attending cardiovascular specialty in tertiary hospitals after the rehabilitation program began. The secondary outcome measures were 6-minute Walk test(6-MWT), psychological evaluation, and assessment of cardiovascular disease risk factors. Results:After 6 months and 12 months of cardiac rehabilitation program, the VO2 peak in CR group was statistically significant compared with the control group, and the 6-MWT index after 12 months was statistically significant.The cardiovascular specialist visits in tertiary hospitals in the two groups were statistically significant. The comparison of psychological self-rating scale and cardiovascular disease risk factors between the two groups was statistically significant after propensity matching analysis.Conclusion:Cardiac rehabilitation has a positive effect on postoperative recovery after small incision aortic valve replacement, and can improve patients’ motor ability.
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Objective To study the morbidity,pathogenesis,diagnosis and treatment of winged scapula.Methods The key words about "winged scapula" have been used to search articles which include winged scapula patients in English and Chinese literature databases from 1958 to 2017.The articles have been filtrated by title,abstract and full text.There are 36 articles used for this study.All the patients are objects of this study,but the same patients' data in different articles have not been used repeatedly.The patients' data have been collected as much as possible,including age,sex,causes,treatment,follow-up and so on.All the patients' data have been used for systematic analysis.Results All of 356 patients with winged scapula were selected from 36 literatures for systematic analysis.There were 213 cases of anterior saw muscle paralysis,among which 16 cases were physical exercise,11 cases were excellent and 5 cases were poor,with an excellent rate of 68.8％.There were 70 cases of neurolysis and transplantation,50 cases were excellent and 20 cases were poor,with an excellent rate of 71.4％.There were 3 cases of scapulectomy,1 case excellent and 2 cases poor.There were 124 cases of pectoralis major tendon metastasis,88 cases were excellent,36 cases were poor,and the excellent rate was 71％.There were 46 cases of trapezius paralysis,among which 14 cases were physical exercise,12 cases were excellent,2 cases were poor,and the excellent rate was 86％.1 case of scapulopexy and 1 case of superior,with an excellent rate of 100％;There were 31 cases of Eden-Lange 31 cases,27 cases of excellent and 4 cases of poor.One case of rhomboid myoplegia was treated,including 1 case of rehabilitation training (ultrasound guidance),1 case of excellent,with an excellent rate of 100％.There were 96 cases of muscular dystrophy,including 96 cases of scapulectomy,76 cases of excellent and 20 cases of poor,with an excellent rate of 79.1％.Conclusion Winged scapula is rare and its incidence is unknown,different causes determine different treatments:Anterior saw muscle palsy is more suitable for thoracolumbar tendon transfer,and modified Eden-Lange is more suitable for trapezius palsy.
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<p><b>OBJECTIVE</b>To provide appropriate guidelines for treatment of tandem ossification of the posterior longitudinal ligament (OPLL) and flaval ligament (OFL). Data sources Published articles about OPLL and OFL were selected using Medline and Embase electronic databases. Study selection An English literature search from January 1980 to December 2006 was conducted. Because many reported cases were incorporated in OFL studies, the key words for search were OFL or OFL and OPLL. The first step revealed 93 studies of which 13 reports of tandem OPLL and OFL (tandem ossification) were selected.</p><p><b>RESULTS</b>All studies were case series or case report and advocated that the primary therapy for tandem ossification should be operative. The clinical outcomes of surgery were evaluated in most reports, predominantly using the JOA scores. Gender is the only factor which has prognostic value. A higher proportion of women was found in the failure group. A two-stage classification of tandem ossification was developed to relate diagnosis to outcome.</p><p><b>CONCLUSIONS</b>All patients with suspected ossification of the spinal ligaments should undergo routine MRI screening of the whole spine. The correlation of the classification with surgical treatments needs further studies to validate its usefulness.</p>
Subject(s)
Female , Humans , Male , Ligamentum Flavum , Pathology , Ossification of Posterior Longitudinal Ligament , Classification , Pathology , Ossification, Heterotopic , Classification , PathologyABSTRACT
<p><b>OBJECTIVE</b>To evaluate the long-term clinical results and the factors that influences the outcomes of the revision open lumbar discectomy by fenestration.</p><p><b>METHODS</b>Fifty-one patients, who underwent the second open discectomy by fenestration from January 1 1988 to December 31 1994, were followed for an average of 146.8 months (range, 120 to 203 months). The long-term follow-up results were evaluated by using the MacNab classification and the Japanese Orthopaedic Association (JOA) scoring system through direct examinations and questionnaires. Radiography was also used in patients who agreed to visit the hospital, and findings were compared with those on preoperative radiographs.</p><p><b>RESULTS</b>At the final follow-up, with the MacNab classification an excellent and good outcome was achieved in 70.6% of the cases, 78.4% were satisfied with their results. The failure rate was 15.7% (8 patients). Excluding those 8 failed cases who needed another reoperation, the average improvement calculated by JOA scores was (64.6 +/- 18.2)%. The disc height of the operation site significantly decreased after surgery, nevertheless, this did not affect the long-term clinical outcome. Factors that were associated with a fair and bad outcome included smoking, isolated trauma or injury, fibrosis and the length of the remaining or recurrent primary postoperative symptoms history. Psychosociological signs were probably known as negative predictors of lumbar disc surgery outcome.</p><p><b>CONCLUSION</b>The long-term outcome of the revision open lumbar discectomy by fenestration in this series was favorable. Because the revision operation is typically associated with a higher complexity, selection of suitable surgical candidates and determination of valid indications for operative treatment are very important. JOA scores have proved to be easy to perform for patients and clinicians and standardize subjective data.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Diskectomy , Methods , Follow-Up Studies , Lumbar Vertebrae , General Surgery , Reoperation , Retrospective Studies , Treatment OutcomeABSTRACT
We only prolongated the course of shock from 2h to 5h, without predi- sposing the dogs. At 5h after hemorrhagic shock, the experimental results were asfollows: The ultrastructural damages were not only detected in the lung but also in theheart, liver, intestine and kidney etc. Major pathological lesions were: swelling of paren-chymal cells in various organs, vacular degeneration, and de-connection of cells. The laterwas shown as disintegration of hepatocyte-conjunction and disappearance of microvilli. Theorganelles of various cells ruptured to different degrees, for example, mitochondria swelledand its crista dissolved, endoplasmic reticulum dilated and de-granulated. In addition, thefibril of cardiac muscle thinned and dissolved, the capillary endothelial tight-conjunctionsof lung and intestine ruptured etc. The quantity of entero-endotoxin in plasma increasedin accordance with prolongation of shock, and its quantity was most abundant in portalvein, the next was artery and the last was hepatic vein. All experimental results showedthat the entero-endotoxin was related to the changes of ultrastructure of various organs.
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AIM and METHOD: In terms of difference value between bleeding blood volume that caused hemorrhagic shouk (HS) and residual blood volume at 2 h after HS, showed that HS at 5.3 kPa level was compen- satory and at 4.0 kPa level was decompensatory. Comparing some blood changes between HS two levels and their changes while pretreated with captopril (Capt. ) to reduce the release of angiotensin Ⅱ (Ang-Ⅱ), so as to inveshgate the significance of Ang - Ⅱ during HS. RESULTS: The residual blood volume in 4.0 kPa HS + Capt. group are again from near "zero" value in simple 4.0 kPa HS group. In both two HS level groups found blood dilution and was not influenced by pretreating with Capt.; contents of K+ and aldosterone increased, but Na+ had no changes, in Capt. + HS group, the former two contents reduced and Na+ had no changes comparing with each HS group. In two HS groups, the bind lactate, lactic dehydrogenase (LDH), blood urea nitrogen (BUN) increased and had more increment in 4.0 kPa HS group. All these changes could be prevented by pretreating with Capt. The blood glucose in 5.3 kPa HS group increased markedly and Capt. had no influence on it, but decreased extremely in 4.0 kPa HS group and Capt. could make it re - increased. CONCLUSIONS: Artery blood pressure (ABP) at 5 .3 kPa level was compensatory HS and ABP at 4 .0 kPa level was decompensatory HS, some changes on decompensatory HS were more serious and severe than compensatory HS, Capt. has protective effects on some changes during HS and could prolong the survival time of decompensatory HS, all that indicated the increment of Aug - Ⅱ is an important pathogenetic factor during HS.