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Objective:To investigate the clinical effect of lateral rectus abdominis approach combined with presacral decompression for surgical treatment of old Denis type II sacral fractures complicated with upper sacral plexus injury.Methods:A retrospective case series study was performed on the clinical data of 9 patients with old Denis type II sacral fractures complicated with upper sacral plexus injury (L 4-S 1) admitted to Zhongnan Hospital of Wuhan University from June 2010 to December 2016. There were 6 males and 3 females, aged (33.1±7.5)years (range, 15-58 years). Embolization of internal iliac artery and preimplantation of abdominal aortic balloon were performed 2 hours before operation under the guidance of digital subtraction angiography (DSA). Surgery was performed using a single lateral rectus abdominis approach combined with presacral decompression. The operation time, intraoperative blood loss and full weight-bearing time were recorded. The visual analogue scale (VAS) and European QOL Five Dimensional health scale (EQ-5D) were compared before and after operation. The Gibbons' impairment scale was used to assess neurological function. X-ray and CT scan were used to observe internal fixation and fracture healing. The complications during and after operation were recorded. Results:The patients were followed up for 24-52 months [(35.2±5.2)months]. The operation time was (2.9±0.6)hours. The intraoperative bleeding was (573±138)ml, and the full weight-bearing time was (11.6±1.2)weeks. X-ray and CT scan showed bone healing in all patients at the latest follow-up. The VAS and EQ-5D scale improved from preoperative (7.8±0.6)points and (0.34±0.07)points to the final follow-up of (0.8±0.3)points and (0.81±0.05)points ( P<0.05). According to Gibbons classification, 8 patients were grade I and 1 patient was grade II one year after operation ( P<0.01). Namely, the radiation pain of lower extremities was significantly improved in all patients, among which 8 patients showed pain disappeared and completely returned to normal and 1 patient showed residual numbness and hypoesthesia of the affected limbs. No major complications (eg, iatrogenic lumbosacral plexus injury, vital blood vessels or pelvic organs injury) occurred during the operation. During the follow-up period, only one patient developed traumatic hip arthritis and underwent total hip arthroplasty 6 months after operation. Fractures of the remaining patients were healed well without complications like infection, pressure ulcer or implant failure. Conclusions:For old Denis type II sacral fractures complicated with upper sacral plexus injury, lateral rectus abdominis approach combined with presacral decompression can fully decompress the upper sacral plexus nerve, relieve pain, and promote functional rehabilitation, with low incidence of complications. It is an alternative surgical method for the treatment of old Denis type II sacral fractures complicated with upper sacral plexus injury.
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Objective@#To observe and compare the clinical efficacy and safety of rifapentine and rifampicin in the treatment of tuberculosis.@*Methods@#From January 2015 to January 2018, 398 tuberculosis patients admitted to Tuberculosis Clinic of the Traditional Chinese Medicine Hospital of Cixi were selected and randomly divided into observation group and control group by complete Random Distribution Method, with 199 cases in each group.The two groups were given basic treatments such as isoniazid, pyrazinamide and ethambutol.On this basis, patients in the control group were treated with rifampicin, and the observation group was treated with rifapentine.The treatment time of both two groups was 6 months.The sputum bacterial conversion rate, lesion absorption rate and cavity closure rate were observed, and the clinical treatment effect and adverse reactions were compared between the two groups.@*Results@#The sputum bacteria conversion rate (77.89%), lesion absorption rate (71.86%) and cavity closure rate (74.87%) in the control group were significantly lower than those in the the observation group(96.98%, 91.96%, 95.98%) (χ2=31.03, 27.13, 35.60, all P<0.01). The total effective rate of the observation group was 93.97%, which was higher than 75.88% of the control group, and the difference was statistically significant (χ2=38.37, P<0.01). The incidence rate of adverse reactions in the observation group was 12.56%, which was significantly lower than 29.56% in the control group, the difference was statistically significant (χ2=17.59, P<0.01).@*Conclusion@#Compared with rifampicin, rifapentine is effective in treating pulmonary tuberculosis patients with high safety and effective improvement of clinical symptoms, which is worthy of further application.
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Objective To observe and compare the clinical efficacy and safety of rifapentine and rifampicin in the treatment of tuberculosis.Methods From January 2015 to January 2018,398 tuberculosis patients admitted to Tuberculosis Clinic of the Traditional Chinese Medicine Hospital of Cixi were selected and randomly divided into observation group and control group by complete Random Distribution Method,with 199 cases in each group.The two groups were given basic treatments such as isoniazid,pyrazinamide and ethambutol.On this basis,patients in the control group were treated with rifampicin,and the observation group was treated with rifapentine.The treatment time of both two groups was 6 months.The sputum bacterial conversion rate,lesion absorption rate and cavity closure rate were observed,and the clinical treatment effect and adverse reactions were compared between the two groups.Results The sputum bacteria conversion rate (77.89％),lesion absorption rate (71.86％) and cavity closure rate (74.87％) in the control group were significantly lower than those in the the observation group(96.98％,91.96％,95.98％) (x2 =31.03,27.13,35.60,all P ＜ 0.01).The total effective rate of the observation group was 93.97％,which was higher than 75.88％ of the control group,and the difference was statistically significant (x2 =38.37,P ＜ 0.01).The incidence rate of adverse reactions in the observation group was 12.56％,which was significantly lower than 29.56％ in the control group,the difference was statistically significant (x2 =17.59,P ＜ 0.01).Conclusion Compared with rifampicin,rifapentine is effective in treating pulmonary tuberculosis patients with high safety and effective improvement of clinical symptoms,which is worthy of further application.
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9 cm in 66 cases and 8 cm in 4 cases.A vaginal speculum was inserted smoothly,showing a pinky,wet,and normal-tensioned vaginal mucous membrane.Of 44 cases with intercourse experience,there were 43 cases with satisfactory sexual life and 1 case with a complaint of too short vagina(vaginal length,8 cm).Conclusions Laparoscopic vaginoplasty of peritoneum has advantages of minimal invasion,simplicity of performance,and rapid recovery.The appearance and functions of "artificial vagina" after surgery are similar to those of normal vagina.