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Objective:To analyze the ideal entry parameters and entry points for C 7 pedicle screws based on three-dimensional CT reconstruction model. Methods:A retrospective case series study was used to analyze the cervical spine CT image data of 50 adult volunteers collected from April 2021 to March 2022 at Taizhou People′s Hospital Affiliated to Nanjing Medical University, including 25 males and 25 females; aged 20-67 years [(43.8±13.5)years]. No significant structural abnormalities were seen in the cervicothorax of all volunteers. First, the 50 CT images were imported into the medical engineering software Mimics 17.0 to reconstruct the three-dimensional C 7 model, and the C 7 pedicle screw diameter (PSD), pedicle screw length (PSL), sagittal angle (SA) and lateral angle (LA) were measured. Then, the anatomical markers, namely the lateral notch and the midpoint of the inferior edge of the C 6 articular process, were used to measure the horizontal distance between the midpoint of the inferior edge of the C 6 articular process and the ideal entry point (line segment A), and the horizontal and vertical distances between the lateral notch and the ideal entry point (line segments B and C). Finally, the lateral notch and the midpoint of the inferior edge of the C 6 articular process were used as markers to observe the distribution of entry points. The values of the above measured parameters were recorded and compared with each other to analyze the differences between different sides and genders. Intra-group correlation coefficients (ICC) were also used to assess intra- and inter-observer agreement. Results:All 100 pedicles from 50 C 7 models were accessed, with the PSD being (6.5±0.7)mm, PSL being (31.8±4.5)mm, SA being (89.8±8.8)°, LA being (31.0±6.7)°, line segment A being 0.9(-0.4, 2.1) mm, line segment B being (5.8±1.7)mm, and line segment C being (3.6±1.5)mm. All ideal entry points were located medial above the lateral notch; moreover, with the midpoint of the inferior edge of the C 6 articular process as a reference, 71 (71%) of the entry points were located laterally and 29 (29%) were located medially. The 12 mm area around the midpoint of the inferior edge of the C 6 articular process was divided into 6 sections, with 47% of the entry points being located within 2 mm lateral to the midpoint, 25% within 2 mm medial to the midpoint, 19% within 2-4 mm lateral to the midpoint, and only 9% within 50% lateral to the midpoint. The measured parameters were not significantly different between the left and right sides (all P>0.05). The PSD, SA, and line segment B in males were (6.8±0.7)mm, (92.0±8.2)°, and (6.3±1.6)mm, which were significantly greater than those in females [(6.2±0.6)mm, (87.5±8.0)°, and (5.3±1.6)mm] (all P<0.01). The remaining parameters were similar between two genders (all P>0.05). All measured parameters had high intra- and inter-observer agreement (ICC: 0.84-0.91), except for line segment A that had moderate intra- and inter-observer agreement (ICC: 0.46-0.63). Conclusions:For C 7 pedicle screw implantation, when the surface of the lateral mass is used as the reference plane, SA is approximately 90°; with reference to the lateral notch, all the ideal entry points are located medially above it; with reference to the midpoint of the inferior edge of the C 6 articular process, approximately 70% of the entry points are located laterally. There are no significant differences in the parameters between the different sides of screw implantation on pedicles. The measured parameters show high intra- and inter-observer agreement, except for line segment A.
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Objective To evaluate whether the forced expiratory volume in sixth scend(FEV6) was the optimal surrogate for forced vital capacity (FVC) in the diagnosis for chronic obstructive pulmonary disease (COPD).Methods Retrospectively analyzed the spirometric data of 142 COPD patients (7 cases with mild COPD,60 cases with moderate COPD,48 cases with severe COPD,27 cases with extremely severe COPD) admitted to Hebei Chest Hospital from October 2011 to October 2012 who had FEV6 data.FEV6,FEV5,FEV4 and FEV3 were measured on volume-time curves and the diagnostic value was analyzed.Results FEV6,FEV5,FEV4 and FEV3 were highly correlated to FVC (r =0.994,0.939,0.935 and 0.923 respectively,P ＜0.001).Assuming =70％ as the diagnostic standard for obstruction,FEV1/FEV6 had a diagnostic rate of 92.96％ with a false negative rate of 7.04％.FEV1/FEV5,FEV1/FEV4 and FEV1/FEV3 had higher false negative rates (9.86％,13.38％ and 27.46％ respectively) than FEV6.The value of FEV1/FEV6-FEV1/FVC had no statistical significance between the mild-moderate and the severe-extremely severe COPD groups(t =1.376,P =0.171).Conclusion There is a strong correlation between FEV6 and FVC.FEV6 may be the best surrogate for FVC in the diagnosis of chronic obstructive pulmonary disease.Elevating diagnostic critical value can reduce the false negative rate.
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ObjectiveTo investigate the clinical therapeutic effect and safety of solifenacin suceinate in the treatment of overactive bladder symptom after benign prostatic hyperplasia (BPH)operation.MethodsAmong 115 patients receiving BPH surgery,58 cases were given solifenacin at bedtime 4 d after surgery for 20 d (treatment group),and 57 cases were given anisodamine after surgery (control group).The urination of patients before and after pulling out catheter were observed,and urodynamic examination,international prostatic symptoms score (IPSS) and overactive bladder symptom score (OABSS) were used to evaluate urination status.ResultsIn treatment group,IPSS and OABSS decreased from 28.3 to 11.3 score and from (14.2±1.2) to (2.9±0.7) score before and after treatment,respectively (P＜0.01).In control group,IPSS and OABSS decreased from 27.3 to 11.8 score (P＜0.01) and from (14.2±1.6) to (11.3±1.1) score before and after treatment,respectively (P＞0.05).ConclusionsThe proper use of solifenacin after prostate operation may release bladder distress and facilitate rehabilitation in patients with overactive bladder symptom.
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Objective The purpose of this study was to determine the efficacy of forced expiratory volume in six seconds(FEV6) as an alternative for forced vital capacity(FVC)and the fixed eat-off points for FEV1/FEV6 in the diagnostic screening for chronic obstructive pulmonary disease (COPD).Methods From August 2007 to December 2008,a total of 1210 spirometric examinations in were analyzed,FEV6 was measured on volume-time curves.The correlation between FEV1/FVC and FEV1/FEV6 was evaluated by the Kendall correlation test.Considering FEV1/FVC