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BACKGROUND:Because of complicated biomechanics of lumbar vertebra, mast facet osteoarthritis, degenerative joint disease and vertebral subluxation usual y occur fol owing lumbar fusion. To avoid adjacent segment disease, researchers have transformed strong internal fixation into elastic fixation, but the treatment outcomes are barely satisfactory. Furthermore, factors involving adjacent segment disease remain unclear. OBJECTIVE:To explore the relationship between L3-4 segment disease fol owing lumbar fusion and gender. METHODS:200 patients undergoing lumbar fusion of L4-5 and L5-S1 in the First Hospital of Shijiazhuang ranging from 2007 to 2016 were enrol ed, and then al otted into male and female groups (n=100 per group) for retrospective analysis. The incidence of L3-4 segment disease was compared between two groups. RESULTS AND CONCLUSION:Compared with the male group, in the female group, the incidence of L3-4 segment diseases at different fusion locations and ranges, the Oswestry disability index and visual analogue scale and each migration range were significantly higher. Logistic regression analysis showed that gender was one of the independent factors of L3-4 segment disease following lumbar fusion of L3-4 and L5-S1. These findings suggest that gender is one of the influencing factors of L3-4 segment disease after instrumented lumbar;thereby, adjacent segment disease occurs frequently in female patients.
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ObjectiveTo assessment the value of strain ratio(SR) in differentiating benign and malignant breast lesions of BI-RADS Ⅳ diagnosed by conventional ultrasound.MethodsElastosonography was performed on 64 patients with breast lesions of BI-RADS Ⅳ diagnosed by conventional ultrasound.SR (strainnormal neighboring tissues /strainbreast lesion) was calculated by the software equipped with the ultrasonic machine.Pathology of the lesions after biopsy or operation was considered as standard,SRs of benign and malignant breast lesions were compared with independent-samples t test.The diagnostic value of SR was evaluated by receiver operating characteristic (ROC) curve analysis.Results SRs of 34 benign breast lesions and 30 malignant breast lesions were 2.85 ± 1.30 and 5.03 ± 2.50 respectively,there was significant difference between them( t =- 4.29,P =0.000).Area under the curve of diagnosing benign and malignant of breast lesions was 0.875 for SR( P ＜0.0001).If the cut-off point of SR was 3.26,the sensitivity in differentiating breast lesions was 83.33％,while the specificity was 82.35％.Conclusions SR is a helpful elasticity parameter for differentiating benign and malignant breast lesions of BI-RADS Ⅳ diagnosed by conventional ultrasound.
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Objective To observe the effect of telbivudine combined with adefuvir dipivoxil in the treatment of Hepatitis B patients with decompensated cirrhosis.Methods 56 Hepatitis B patients with decompensated cirrhosis were divided into two groups:treatment group (30 cases) and control group (26 cases).During 24 weeks,the control group received adefuvir dipivoxil( 10mg daily),supportive and symptomatic treatments,while the treatment group received telbivudine therapy(600mg daily) combiled with adefuvir dipivoxil ( 10mg daily) based on the regular treatments.After 24 weeks,the effect was observed and compared between the two groups.Results After treatment,the biochemical markers,Child-Pugh score of the treatment group was (33.2 ± 13.8) μmol/L,(44.5 ± 16.4) U/L,(36.1 ±1.5) g/L,(6.1 ± 1.8) points,respectively,and was better than those of the control group[ (71.8 ±18.6) μ mol/L,(89.9 ±44.9) U/L,(29.7 ± 1.3)g/L,(8.1 ±2.2) points] (t=15.32,15.20,23.37,6.09,all P＜0.05) ;HBV-DNA negative rate,HBeAg seroconversion rates of the treatment group was 93.3％ (28/30),43.3％(13/30),and was higher than that of the control group[76.9％ (20/26),7.6％ (2/26) ] (x2 =4.87,9.08,all P＜0.05).Conclusion Telbivudine combined with adefuvir dipivoxil was effective and safe for the treatment of Hepatitis B patients with decompensated cirrhosis.
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Objective To investigate the safety and efficiency of large-dose alcohol sclerotherapy in treating simple hepatic cyst. Methods Patients with hepatic cyst were divided into two groups. One group with 49 patients was treated with small-dose (<80 ml) absolute alcohol instillation. The other one with 32 patients was treated with large-dose (≥80 ml) absolute alcohol instillation. Blood alcohol concentration (BAC) was recorded right after and 30 rain, 1 h,2 h,3 h after the treatment. Diameter of cyst as a parameter of efficiency was recorded and compared between two groups during 1 year follow-up visit. Results Large-dose group was significantly more efficient in treating hepatic cyst than small-dose group. All BAC records were within the safe range and below the legal limit after drinking. BAC reached its peak 30 minutes after the treatment began and then decreased gradually. A significant correlation was found between BAC and the alcohol dosage. Conclusions Ultrasound-guided sclerotherapy with repeated large-dose absolute alcohol instillation is a safe and efficient treatment for simple hepatic cyst from the perspective of BAC.
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【Objective】To observe the effect of Huangqi Sijunzi Decoction(HSD) combined with parenteral nutrition in promoting postoperative recovery of gastric cancer patients.【Methods】Eighty gastric cancer patients were randomized into two groups.On the 3rd day after operation,the two groups received parenteral nutrition,and the treatment group(group A) was given HSD additionally.The anal exsufflation time,incision infection rate,biochemical indexes and immune indexes of the two groups were observed.【Results】The anal exsufflation time was(2.40?0.33) days in the treatment group and(3.82?0.26) days in the control group,the difference being significant(P0.05).The increase of pre-albumin in the treatment group was obvious as compared with that in the control group(P0.05).The increase of immune indexes was not obvious in the control group(P
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Objective:To evaluate the levels of interleukin 18(IL-18) mRNA in peripheral blood mononuclear cells(PBMCs),livers and spleens in monkey endotoxic shock models.Methods:Cynomolgus monkeys were injected i.v. with lipopolysaccharide(LPS) (2.8 mg/kg) to prepare the endotoxic shock models. The mRNA levels of IL-18 in PBMCs,livers and spleens were tested by fluorescence semi-quantitative realtime reverse transcription(RT)-PCR and compared with that of TNF-? and IL-1?.Results:IL-18 mRNA expression in PBMCs remarkably increased at 120 min after LPS administration, so did in livers and in spleens at the same time. mRNA levels of TNF-? in PBMCs peaked at 60 min after LPS injection, and also increased markedly at 120 min in livers and spleens. IL-1? mRNA levels peaked at 60 min in PBMCs, and did not change so much in livers and in spleens.Conclusion:IL-18 mRNA expression in PBMCs can be up-regulated by LPS, but changed latterly than TNF-? and IL-1? in endotoxic shock cynomolgus monkeys. It is presumed that IL-18 can be produced by PBMCs and liver Kupffer cells(maybe splenic macrophages),and TNF-? is produced by a variety of cells, but IL-1? in bloodstream mainly come from PBMCs after LPS challenge.