ABSTRACT
OBJECTIVE@#To study the effect of intermittent versus daily inhalation of budesonide on pulmonary function and fractional exhaled nitric oxide (FeNO) in children with mild persistent asthma.@*METHODS@#A total of 120 children, aged 6-14 years, with mild persistent asthma who attended the hospital from January 2016 to January 2018 were enrolled. The children were divided into an intermittent inhalation group with 60 children (inhalation of budesonide 200 μg/day for 6 weeks when symptoms of asthma appeared) and a daily inhalation group with 60 children (continuous inhalation of budesonide 200 μg/day) by stratified randomization. The children were followed up at months 3, 6, 9, and 12 of treatment. The two groups were compared in terms of baseline data, changes in FeNO and pulmonary function parameters, amount of glucocorticoid used, number of asthma attacks, and asthma control.@*RESULTS@#At the start of treatment, there were no significant differences in baseline data, FeNO, and pulmonary function between the two groups (P>0.05). Over the time of treatment, FeNO gradually decreased and pulmonary function parameters were gradually improved in both groups (P0.05). Compared with the daily inhalation group, the intermittent inhalation group had a significantly lower amount of budesonide inhaled (P<0.05) and a significantly higher number of asthma attacks (P<0.05).@*CONCLUSIONS@#Intermittent inhalation and daily inhalation of budesonide can achieve the same level of asthma control in children with mild persistent asthma and both have no influence on the increases in body height and body weight. Daily inhalation of budesonide can produce a better efficiency in reduing FeNO and increasing FEV1%pred. Although intermittent inhalation can reduce the amount of glucocorticoid used, it may lead to a higher risk of asthma attacks.
Subject(s)
Adolescent , Child , Humans , Administration, Inhalation , Asthma , Drug Therapy , Budesonide , Therapeutic Uses , Forced Expiratory Volume , Nitric OxideABSTRACT
BACKGROUND: There are many studies on Modic changes in patients with lumbar degenerative disease and low back pain. However, few studies facus on epidemiological distribution and related factors of Modic changes in cervical spine, and its epidemiology and influencing factors remain unclear.OBJECTIVE: To study the morbidity and distribution of Modic changes in patients with cervical and shoulder pain and its correlation with gender, age and cervical degeneration. METHODS: Totally 430 patients admitted in the Second Affiliated Hospital of Inner Mongolia Medical University and undergoing cervical MRI and CT examination due to neck and shoulder pain between December 2014 and December 2016 were retrospectively analyzed, involving 197 males and 233 females, aged 19-78 years (mean age: 50.3 years). The morbidity and segmental distribution of Modic changes and its correlation with age, sex, cervical intervertebral disc degeneration and facet joint degeneration were analyzed. RESULTS AND CONCLUSION: (1) Among 2 150 disc segments of 430 patients, 348 segments (16.2%) of 67 patients (15.6%) appeared with Modic changes:73(3.4%)segments were type I,243(11.3%)were type II,and 32(1.5%)were type III.(2)By application of chi-square test, Modic changes were most common at the C5/6segment; older than 40 years and Pfirrmann disc degeneration grade III were relevant factors, while gender and facet joint degeneration were not.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the advantages and indications of the paraspinal approach by anatomical study and clinical application.</p><p><b>METHODS</b>The anatomical data and clinical practice of 27 cases were analyzed to explore the accurate approach between the paraspinal muscles and the structure of ambient tissues, as well as the results of clinical application of paraspinal approach. The operation time, blood loss, incision length, radiographic result (Cobb angle, height of anterior edge of the vertebrae) were compared with those in 24 cases treated by traditional approach.</p><p><b>RESULTS</b>Complete exposure of the facets could be easily performed by identifying natural cleavage plane between the multifidus and longissimus muscles. The natural muscular cleavage was (1.47+/-0.23) cm lateral to the midline for females, and (1.64+/-0.35) cm for males at T(12) level. The distance was (3.3+/-0.6) cm lateral to the midline for females, and (3.7+/-1.0) cm for males at L(4) level. In paraspinal approach group, the operation time was (76.2+/-15.7) min, blood loss was (91.6+/-16.9) ml and incision length was (7.6+/-0.8) cm. In traditional approach group, the operation time was (121.4+/-19.6) min, blood loss was (218.7+/-32.3) ml and incision length was (17.4+/-2.1) cm. To compare paraspinal approach with traditional approach, the operation time, blood loss and incision length had statistical difference (P less than 0.05) and the radiographic result (Cobb angle, height of anterior edge of the vertebrae) had no statistical difference (P larger than 0.05).</p><p><b>CONCLUSIONS</b>When the paraspinal approach is performed through natural cleavage plane between the multifidus and longissimus muscles, there are no wide muscular disinsertions, leaving the supraspinous and interspinous ligaments intact. The distance of natural cleavage to the midline is different at T(12) and L(4) planes. By this approach, the facet joints can be explored easily and completely, and a clear surgical field will be available for the placement of pedicle screws. As a minimally invasive approach, it can be widely used in thoracolumbar spine surgery.</p>