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1.
Chinese Journal of Trauma ; (12): 422-428, 2021.
Article in Chinese | WPRIM | ID: wpr-909886

ABSTRACT

Objective:To explore different surgical treatment options and effect for intraspinal cement leakage after percutaneous vertebroplasty (PVP).Methods:A retrospective case series study was carried out to analyze the clinical data of 5 patients with intraspinal cement leakage after PVP for osteoporotic vertebral compression fracture (OVCF) admitted to People's Hospital of Shanxi between May 2016 and January 2020, including 1 male and 4 females, with the age of 65-82 years [(75.4±7.5)years]. Injured segments were located at T 12-L 1 in 1 patient, L 1 in 1, L 2-4 in 1, L 3 in 1 and L 4-5 in 1. The American Spinal Injury Association (ASIA) classification was grade C in 2 patients and grade D in 3. Muscle strength was grade II in 2 patients and grade III in 3. The leakage of bone cement in the spinal canal was strip or columnar in 3 patients, leaning to one side of the spinal canal and adjacent to the nerve root, and the bone cement was removed by transforaminal endoscope for decompression. The leakage of bone cement in the dura mater and spinal canal was found in 2 patients. The intradural bone cement leakage was removed by durotomy, and the bone cement in the spinal canal was removed by transpedicular osteotomy, bone graft fusion and internal fixation. The visual analogue scale (VAS), Oswestry dysfunction index (ODI), ASIA grade and muscle strength were observed before operation, at 3 days, 3 months after operation and at the last follow-up. Results:All patients were followed up for 12-16 months [(13.6±1.8)months]. The VAS was significantly decreased at postoperative 3 days, 3 months and at the last follow-up [(2.6±0.6)points, (2.1±0.3)points, (1.9±0.5)points] when compared to (7.1±1.5)points before operation ( P<0.01). However, the VAS had no statistical difference at different time points after operation ( P>0.05). The ODI was 42.4±10.2, 25.6±6.0 and 21.4±3.6 at postoperative 3 days, 3 months and at the last follow-up, significantly different from that before operation (74.2±7.3) ( P<0.05 or 0.01). However, the ODI had no statistical difference at postoperative 3 months and at the last follow-up ( P>0.05). Two patients with preoperative ASIA grade C recovered to grade D and 3 patients with preoperative grade D recovered to grade E at the last follow-up ( P<0.05). Two patients could walk without crutches with muscle strength improved from grade II preoperatively to grade IV at the last follow-up ( P<0.01). Three patients had completed recovery of neurological function with muscle strength improved from grade III preoperatively to grade V at the last follow-up ( P<0.01). Conclusions:For OVCF patients with intraspinal canal cement leakage and neurological symptoms after PVP, if the bone cement is located on one side of the spinal canal and adjacent to the nerve root, the bone cement should be removed by foraminal endoscope for decompression; if the cement leakage occurs in the dura mater, the dura mater should be cut to remove the bone cement for decompression, which can effectively relieve pain and promote functional recovery.

2.
Chinese Journal of Urology ; (12): 274-277, 2021.
Article in Chinese | WPRIM | ID: wpr-885003

ABSTRACT

Objective:To discuss the clinical efficacy of laparoscopic radical cystectomy in the treatment of bladder cancer after partial cystectomy.Methods:The clinical data of 30 patients who underwent laparoscopic radical cystectomy after PC in Sichuan Provincial People's Hospital from March 2016 to August 2020 were retrospectively analyzed. Including 24 males and 6 females with an average age was 62.5 (45.5-82.5)years.6 out of 30 cases underwent pelvic lymph node dissection during PC. All patients had definite pathological diagnosis for the high-grade urothelial carcinoma after PC, and the tumor staging was pT 2-3bN 0M 0.5 patients received postoperative adjuvant chemotherapy with gemcitabine and cisplatin, 6 received postoperative adjuvant radiotherapy, 13 received postoperative adjuvant radiotherapy and chemotherapy, and all patients were received maintenance intravesical instillation. Median time for local tumor recurrence after PC was 9(5-29) months, all patients had pathological diagnosis for the high-grade papillary urothelial carcinoma, cT 2-4N 0M 0 stage.The average tumor diameter was 3.5(2.5-4.5)cm, an average number of tumors was 2(1-3). Laparoscopic salvage cystectomy was performed after recurrence.General anesthesia, supine position, 5 ports were inserted through the abdominal approach. Standard pelvic lymph node dissection (PLND) was used to clean the pelvic lymph nodes. Those who had underwent PLND no longer clean the obturator and peripheral iliac vessels, but including the common iliac vessel and the bifurcation of the abdominal aorta and lymphatic tissues around the inferior vena cava, as well as the presacral lymph nodes. Results:All 30surgeries were successfully performed. The average operative time was 270(240-310)min, average estimated intraoperative blood loss was 180(50-300)ml, and there was no blood transfusion during the perioperative period.The average number of lymph nodes dissected was 18 (10-27). There were 4 cases with positive lymph nodes, of which 3 cases were positive for 2 obturator lymph nodes, and 1 case was positive for 3 obturator and external iliac lymph nodes. No serious intraoperative complications occurred.No lymphatic leakage occurred. The average drainage duration was 4(3-7) d, and postoperative hospital stays was 9(7-20)d. The postoperative pathology was invasive high-grade papillary urothelial carcinoma, and pathological TNM stage was pT 2-4aN 0-2M 0.13 patients received postoperative adjuvant chemotherapy. The average postoperative follow-up time was 23(3-31) months. There were 2 cases of pelvic recurrence and 1 case of retroperitoneal lymph node metastasis. These 3 cases received adjuvant chemotherapy and radiotherapy. Conclusions:Radical cystectomy should be the primary treatment for recurrence of bladder cancer after partial cystectomy.

3.
Article in Chinese | WPRIM | ID: wpr-888391

ABSTRACT

OBJECTIVE@#To carry out genetic testing for a pregnant woman with mild mental retardation, facial dysmorphism, and a history of adverse pregnancies and provide prenatal diagnosis for her.@*METHODS@#Routine G-banded karyotyping and single nucleotide polymorphism microarray (SNP-array) analysis were performed on the couple and amniotic fluid sample.@*RESULTS@#No karyotypic abnormality was found with the couple and amniotic fluid sample. SNP-array analysis showed that the woman has carried a 7.801 Mb microdeletion in 10q22.3q23.2, which involved 18 OMIM genes including CDHR1, BMPR1A, NRG3, GRID1 and LDB3, which are associated with facial abnormalities, developmental retardation, mental retardation and autism. The fetus also carried a 7.819 Mb deletion in the same region, while the father showed no abnormality.@*CONCLUSION@#Both the pregnant woman and her fetus have carried a 10q22.3q23.2 microdeletion, which has provided guidance for her subsequent pregnancy.


Subject(s)
Cadherins , Chromosome Banding , Chromosome Deletion , Female , Fetus , Genetic Testing , Humans , Karyotyping , Nerve Tissue Proteins , Pregnancy , Prenatal Diagnosis
4.
Article in Chinese | WPRIM | ID: wpr-826469

ABSTRACT

OBJECTIVE@#To provide prenatal diagnosis for a pregnant women carrying a chromosome translocations using single nucleotide polymorphism array (SNP-array).@*METHODS@#The fetus and its parents were subjected to chromosome karyotyping and SNP array analysis.@*RESULTS@#A Xp22.12 microduplication was identified in the fetus with a size of 496.3 kb. Search of literature and database indicated the microduplication to be variant of unclear significance. The phenotypically normal mother has carried a 505.8 kb duplication at the same position. The father was normal for the testing. The couple decided to continue with the pregnancy and gave birth to a healthy girl at full-term. No abnormality was found during the follow-up.@*CONCLUSION@#The Xp22.12 microduplication encompassed part of RPS6KA3 gene, which shows various features of Coffin-Lowry syndrome. Female with Xp22.12 microduplications may be asymptomatic carriers due to X chromosome inactivation. Our case may provide data for delineating the phenotype-genotype correlation of Xp22.12 microduplication.

5.
Journal of Chinese Physician ; (12): 474-477, 2020.
Article in Chinese | WPRIM | ID: wpr-867258

ABSTRACT

Circadian rhythm disorder is a common physiological change of cancer survivors, which is mainly manifested in rest activity rhythm change, sleep wake disorder and the decrease of sleep efficiency at night, which further affect their physiological, psychological outcome and disease outcome. This paper reviews the concept, mechanism, influence and intervention methods of circadian rhythm disorder in cancer patients, in order to provide references for effective intervention of circadian rhythm disorder in cancer survivors.

6.
Article in Chinese | WPRIM | ID: wpr-824352

ABSTRACT

Objective To discuss the ethical necessity and feasibility of implementing multiple comprehensive psychological intervention measures in intensive care unit (ICU), and to investigate the effect of the measures on treatment compliance. Methods The conscious adult patients hospitalized in emergency ICU (EICU) of the Second Affiliated Hospital of Xi'an Jiaotong University from 2015 to 2017 were enrolled, and divided into control group and intervention group according to random number table, with 40 patients in each group. Patients in control group were treated with routine care and routine diagnosis and treatment, and patients in intervention group were treated with the help of psychologists and with multiple comprehensive psychological intervention measures (including nursing care, medical treatment, family and management) based on routine care and routine diagnosis and treatment. After 5 days of intervention, the treatment compliance, the medical coping attitude and the mental health were assessed respectively using the Treatment Compliance Scale, the Medical Coping Modes Questionnaire (MCMQ) and the Symptom Checklist Scale (SCL-90), and then comparation were done between the two groups. Results After 5 days of intervention, 3 patients in the control group and 4 patients in the intervention group withdraw the study because of the change of illness, and at last 37 patients in the control group and 36 in the intervention group were enrolled. There was no significant difference in basic data such as gender, age, education level, disease, course of disease, the length of EICU stay, and acute physiology and chronic health evaluationⅡ (APACHEⅡ) score between the two groups. The scores of treatment compliance in intervention group was significantly higher than that in control group (2.89±0.67 vs. 2.32±0.91, P < 0.01). Compared with the control group, the "confrontation" dimension score of the MCMQ questionnaire in intervention group was significantly increased (19.75±2.08 vs. 18.62±2.65, P < 0.05), while the "avoidance" and"surrender" dimensions scores were significantly decreased (14.22±1.91 vs. 15.14±1.92, 8.83±1.54 vs. 9.73±2.10, both P < 0.05). In the SCL-90 scale, the scores of the 5 factors such as "somatization", "interpersonal sensitivity","depression", "anxiety" and "photic anxiety" in intervention group were significantly less than those in control group (1.59±0.38 vs. 1.81±0.37, 1.72±0.40 vs. 1.93±0.42, 1.76±0.32 vs. 1.92±0.29, 1.82±0.40 vs. 2.14±0.40, 1.44±0.30 vs. 1.60±0.38, all P < 0.05), while there was no significantly difference in the scores of the other 4 factors as "obsessive-compulsive symptoms", "hostile", "bigotry" and "psychoticism" between the two groups (all P > 0.05). Conclusion The multiple comprehensive psychological intervention measures used for ICU conscious patients could improve the treatment compliance, make the patients' medical coping attitude more active and improve the mental health of the patients, so it has ethical necessity and certain feasibility.

7.
Article in Chinese | WPRIM | ID: wpr-823698

ABSTRACT

Pertussis is an acute highly contagious respiratory disease,which is associated with high rate of hospitalization and death in infants and young children.The pathogenesis of severe pertussis has not been elucidated,and there has not been a consistent universal definition in severe pertussis.This article summarizes the present clinical definitions of severe pertussis related diagnosis,and the risk factors for death from pertussis.This text could benefit the clinical practice and the further researches,and to contribute to establish a regulation of the diagnosis and treatment of severe pertussis early.

8.
Article in Chinese | WPRIM | ID: wpr-746283

ABSTRACT

Objective This study aimed to assess the diagnostic value of anti-mutated citrullinated vimentin (MCV) antibodies in rheumatoid arthritis (RA) and its correlation with disease progression, extra-articular manifestations and overlap syndrome. Methods Retrospective Studies. Clinical data of 837 patients in PekingUnionMedicalCollegeHospitalfrom June to August 2017 were collected, including the result of anti-MCV, anti-cyclic citrullinated peptide (anti-CCP) antibodies, rheumatoid factor (RF), erythrocyte sedimentation rate (ESR) and High-sensitivity-C-reactive protein (CRP). According to the 1987 American College of Rheumatology classification criteria for rheumatoid arthritis, there were 323 patients diagnosed with RA, including 59 males and 264 females with the average age of 51 years. According to whether the RA patients have overlap syndrome with other autoimmune disease (AID) or have extra-articular manifestations, 258 cases were categorized into RA group, including 47 males and 211 females with the average age of 50 years; 14 cases were categorized into the group of overlap syndrome, including 1 male and 13 females with the average age of 36 years;51 cases were categorized into the group of extra-articular manifestations, including 11 males and 40 females with the average age of 59 years.According to 2010 rheumatoid arthritis classification criteria for destruction in joints, the radiographic changes were divided into 4 stages. There were 203 casesenrolled in our study, 88 caseswere fitted into early stage group (stage I)including 21 males and 67 females with the average age of 48 years; 115 caseswere fitted into progressive stage group, which compromisedstageⅡ (interim stage), stage Ⅲ (severe stage) and stage Ⅳ(final stage) cases, including 19 males and 96 females with the average age of 53 years. Mann-Whitney U test, x2 test, Receiver operating characteristic (ROC) curves and Spearmancorrelation coefficientwere used in Statistical analysis. Results Ⅰ Amongdiagnosed RA patients, 199 (61.6%) cases were positive for anti-MCV, anti-CCP and RFsimultaneously, 42 (13%) cases were positive for anti-MCV, which was higher than anti-CCP positive (1 cases, 0.3%) or RF positive (7cases, 2.2%). The difference was statistically significant(P<0.001, P<0.001). ⅡROC was calculated and MCV=35.95 U/ml was used as best-fit cut-off value. The AUC for anti-MCV was 0.867, while the sensitivity was 80.5%and specificity was 80.9%.ⅢThe detection levels of anti-MCV (682.8 (106.4-1000.0)), anti-CCP (407 (4.0-1536.0)) and RF (82.8 (21.1-244.9)) in the group of progressive stage were higher than those in the group of early stage (114.5 (28.5-1000.0), 62.5 (5.0-1020.7), 50.1 (6.7-127.1)), which showed a significant difference(P<0.05, P<0.05, P<0.05). The anti-MCV, anti-CCP and RF were positively related to the degree of joint destruction (r=0.229, P<0.05;r=0.187, P<0.05;r=0.167, P<0.05);anti-MCV and anti-CCP were positively related to extra-articular manifestation (r=0.152, P<0.05;r=0.136, P<0.05). Conclusion Anti-MCV antibodies are more sensitive in patients with RA, and have complementary diagnostic value for anti-CCP and RF-negative patients; high levels of anti-MCV and anti-CCP in RA patients are associated with RA progression and extra-articular involvement.

9.
Article in Chinese | WPRIM | ID: wpr-752290

ABSTRACT

Objective To analyze the infection composition and drug resistance to Gram-negative (G-) bacilli in children's respiratory tract in Suzhou,in order to provide evidence for rational use of antibiotics clinically.Methods G-bacilli culture samples were collected from 21 561 cases of nasopharyngeal secretions from patients with respiratory tract infection admitted at the Department of Respiratory,Children's Hospital of Soochow University from January 2007 to December 2016,including 21 246 cases in general wards,and 315 patients who were transferred to the respiratory department after treatment in the Intensive Care Unit(ICU),and the children were divided into the general ward group and the ICU group,and the pathogens were compared and the changes in bacterial susceptibility were dynamically observed between the 2 groups.Results The primary G-bacteria for respiratory infection was Haemophilus influenzae,followed by Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa and Acinetobacter baumannii.The detection rates of Klebsiella pneumoniae and Pseudomonas aeruginosa in the ICU group were 16.8% (21/125 strains) and 14.4% (18/125 strains),respectively,which were significantly higher than those in the general ward group [10.0% (208/2 071 strains),9.2% (190/2 071 strains)].The detection rates of G-bacteria in the ICU group were 33.7% (106/315 cases),which were significantly higher than those in the general ward group [9.4% (1 997/21 246 cases)],and the difference was statistically significant (x2 =210.325,P < 0.001).The rare G-bacillus such as Stenotrophomonas maltophilia,Acinetobacter junii and Burkholderia onion were higher in the ICU group [17.6% (22/125 strains)] than that in the general ward group [6.4% (132/2 071 strains)].The rate that of G bacteria with two or more mixed infection in ICU group [17.0% (18/106 cases)] was significantly higher than in the general ward group [3.4% (68/1 997 cases)],and the difference was statistically sigmficant(x2 =47.3,P <0.05).For the mixed infection,the ICU group was mainly composed of Klebsiella pneumoniae mixed with Pseudomonas aeruginosa or Escherichia coli,while the general ward group was composed of Haemophilus influenzae mixed with Pseudomonas aeruginosa or Escherichia coli.The sensitivity of Haemophilus infiuenzae to Ampicillin,Sultamicillin,Cefuroxime,Cefaclor and Azithromycin decreased,and the sensitivity to Chloramphenicol,Tetracycline and Trimethoprim + Sulfamethoxazole increased year by year,and there were statistically significant differences in different years (all P < 0.05).The sensitivity to Escherichia coli to Ceftazidime decreased year by year,and the sensitivity to Ampicillin and Levofloxacin increased year by year,and there were statistically significant differences in different years (all P < 0.05).The sensitivity to Klebsiella pneumoniae to Cefoperazone/Sulbactam and imipenem decreased,and the sensitivity to Ciprofloxacin and Levofloxacin increased,and there were statistically significant differences in different years (all P < 0.05).The sensitivity to Pseudomonas aeruginosa,Cefoperazone/Sulbactam and Ceftriaxone decreased year by year,and the sensitivity to Levofloxacin increased,and there were statistically significant differences in different years (all P < 0.05).The detection rate of carbapenem-resistant strains of Klebsiella pneumoniae and Pseudomonas aeruginosa showed an increasing trend,and there were statistically significant differences in different years (all P < 0.05).Conclusions The primary G-bacteria for respiratory infections is Haemophilus influenzae,G-bacilli especially,the mixed infection of G-bacilli,is more likely to cause severe and critical respiratory infections.The resistance rate of G-bacteria infection in children's respiratory tract to commonly used antibiotics is generally on the rise.

10.
Article in Chinese | WPRIM | ID: wpr-796570

ABSTRACT

Objective@#To analyze the infection composition and drug resistance to Gram-negative (G-) bacilli in children′s respiratory tract in Suzhou, in order to provide evidence for rational use of antibiotics clinically.@*Methods@#G- bacilli culture samples were collected from 21 561 cases of nasopharyngeal secretions from patients with respiratory tract infection admitted at the Department of Respiratory, Children′s Hospital of Soochow University from January 2007 to December 2016, including 21 246 cases in general wards, and 315 patients who were transferred to the respiratory department after treatment in the Intensive Care Unit(ICU), and the children were divided into the general ward group and the ICU group, and the pathogens were compared and the changes in bacterial susceptibility were dynamically observed between the 2 groups.@*Results@#The primary G-bacteria for respiratory infection was Haemophilus influenzae, followed by Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii.The detection rates of Klebsiella pneumoniae and Pseudomonas aeruginosa in the ICU group were 16.8% (21/125 strains)and 14.4%(18/125 strains), respectively, which were significantly higher than those in the general ward group [10.0%(208/2 071 strains), 9.2%(190/2 071 strains)]. The detection rates of G-bacteria in the ICU group were 33.7%(106/315 cases), which were significantly higher than those in the general ward group [9.4%(1 997/21 246 cases)], and the difference was statistically significant(χ2=210.325, P<0.001). The rare G-bacillus such as Stenotrophomonas maltophilia, Acinetobacter junii and Burkholderia onion were higher in the ICU group [17.6%(22/125 strains)] than that in the general ward group [6.4% (132/2 071 strains)]. The rate that of G-bacteria with two or more mixed infection in ICU group [17.0% (18/106 cases)] was significantly higher than in the general ward group [3.4%(68/1 997 cases)], and the difference was statistically significant(χ2=47.3, P<0.05). For the mixed infection, the ICU group was mainly composed of Klebsiella pneumoniae mixed with Pseudomonas aeruginosa or Escherichia coli, while the general ward group was composed of Haemophilus influenzae mixed with Pseudomonas aeruginosa or Escherichia coli.The sensitivity of Haemophilus influenzae to Ampicillin, Sultamicillin, Cefuroxime, Cefaclor and Azithromycin decreased, and the sensitivity to Chloramphenicol, Tetracycline and Trimethoprim+ Sulfamethoxazole increased year by year, and there were statistically significant differences in different years (all P<0.05). The sensiti-vity to Escherichia coli to Ceftazidime decreased year by year, and the sensitivity to Ampicillin and Levofloxacin increased year by year, and there were statistically significant differences in different years (all P<0.05). The sensitivity to Klebsiella pneumoniae to Cefoperazone/Sulbactam and imipenem decreased, and the sensitivity to Ciprofloxacin and Levofloxacin increased, and there were statistically significant differences in different years (all P<0.05). The sensitivity to Pseudomonas aeruginosa, Cefoperazone/Sulbactam and Ceftriaxone decreased year by year, and the sensitivity to Levofloxacin increased, and there were statistically significant differences in different years (all P<0.05). The detection rate of carbapenem-resistant strains of Klebsiella pneumoniae and Pseudomonas aeruginosa showed an increasing trend, and there were statistically significant differences in different years (all P<0.05).@*Conclusions@#The primary G-bacteria for respiratory infections is Haemophilus influenzae, G-bacilli especially, the mixed infection of G-bacilli, is more likely to cause severe and critical respiratory infections.The resistance rate of G-bacteria infection in children′s respiratory tract to commonly used antibiotics is generally on the rise.

11.
Article in Chinese | WPRIM | ID: wpr-803234

ABSTRACT

Pertussis is an acute highly contagious respiratory disease, which is associated with high rate of hospitalization and death in infants and young children.The pathogenesis of severe pertussis has not been elucidated, and there has not been a consistent universal definition in severe pertussis.This article summarizes the present clinical de-finitions of severe pertussis related diagnosis, and the risk factors for death from pertussis.This text could benefit the clinical practice and the further researches, and to contribute to establish a regulation of the diagnosis and treatment of severe pertussis early.

12.
Article in Chinese | WPRIM | ID: wpr-710510

ABSTRACT

Objective To investigate the effects of enhanced recovery after surgery (ERAS) combined with laparoscopic common bile duct exploration (LCBDE) in elderly patients with choledocholithiasis.Methods From Jan 2015 to Dec 2016,in the control group 40 patients received conventional perioperative management and 40 patients in the ERAS group followed the ERAS protocol.The operative details and outcomes were compared in the two groups.Results No perioperative death occurred during the study period.There was no statistically significant difference between the two groups in operative time and intraoperative blood loss (t =1.04,0.88,P >0.05).Patients in ERAS group showed significantl shorter time of gastrointestinal tract peristalsis,off-bed,postoperative infusion,food intake,and abdominal drainage tube removal,as well as reduced weight loss,length of hospital stay and total cost than those in the control group (P < 0.05).There were no significant difference of preoperative CRP and PCT,IL-6 in the 2 groups (t =1.18,0.44,1.49,P > 0.05),However,the CRP and PCT,IL-6 levels in ERAS group were significantly lower than those in control group at postoperative days 1,4,7 (P < 0.05).Furthermore,postoperative complications developed in 3 (7.5%),and 12 (30.0%) respectively (x2 =6.47,P < 0.05).Conclusions Minimally invasive surgery combined with ERAS is safe and cost-effective approach for elderly patients of choledocholithiasis.

13.
Chinese Journal of Trauma ; (12): 157-163, 2018.
Article in Chinese | WPRIM | ID: wpr-707285

ABSTRACT

Objeetive To investigate the clinical efficacy of inverted intmmedullary nail combined with medial minimally invasive plate in treatment of type C2 and C3 distal femoral fractures.Methods A retrospective case control study was conducted on 38 patients with complex distal fractures of the femur treated from January 2015 to January 2017.There were 22 males and 16 females,aged 24-72 years [(45.6 ± 2.5)years].AO fracture classification was type C2 in 24 patients and type C3 in 14.All of them were fresh closed fractures.The time duration from injury to operation was 4-16 days (average,7.5 days).Based on the different surgical methods,the patients were divided into lateral single plate fixation group (single plate group,20 patients) and inverted intramedullary nail combined with medial minimally invasive locked plate fixation group (locked plate group,18 patients).The two groups were compared in terms of operation condition,early weight bearing time,fracture healing time,postoperative complications,postoperative knee function and activity of living.Hospital for Special Surgery (HSS) score was used for evaluating postoperative knee function and Barthel index for activity of living.Results The patients were followed up for 10-24 months [(12.2 ± 1.8) months].The operation duration was (110.5 ± 35.4) min for single plate group and (116.7 ± 42.3) min min for locked plate group(P >0.05).Intraoperative blood loss in single plate group was [(450.5 ± 120.7)ml] and [(455.2 ± 130.4) ml] in locked plate group (P > 0.05).The early weight bearing time in single plate group was (28.5 ± 8.6)days and 18.7 ± 4.9 (P < 0.01)days in the locked plate group.The fracture healing time in single plate group was (8.5 ± 2.2) months,and [(6.5 ± 1.6) months] in locked plate group (P < 0.01).After 3 weeks,6 months and 12 months,HSS scores of knee joint function of the locked plate group was significantly better than that of single plate group (P < 0.01).At 6 months and 12 months after operation,Barthel index score of locked plate group was significantly better than that of single plate group (P < 0.01).No infection occurred in two groups after operation.There were no complications such as internal fixation failure,knee valgus,external rotation deformity or fat embolism in locked plate group.There were two cases of internal fixation failure,one knee eversion,and two knee varus in single plate group (P < 0.01).Conclusion Compared with single plate fixation,the therapeutic method of inverted intramedullary nail combined with medial minimally invasive locked plate has the advantages of early weight bearing time,quick recovery,better function restoration and fewer complications,and hence is a preferable choice for treatment of type C2 and C3 complex distal femoral fractures.

14.
Chinese Journal of Neonatology ; (6): 113-117, 2018.
Article in Chinese | WPRIM | ID: wpr-699282

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Objective To study the value of multi-channel video electroencephalogram (VEEG) in evaluating the severity and the prognosis of hypoxic-ischemic encephalopathy (HIE) in full-term neonates.Method From September 2015 to December 2016,full-term newborns of suspected brain damage were admitted to Kunming Children's Hospital and received multi-channel VEEG within 6 hours after birth and MRI within one week.6 months after treatment,mental development index (MDI) and psychomotor development index (PDI) score were calculated.Finally,the relationship of VEEG and the prognosis of HIE was evaluated.Result Among 123 cases in our study,the total anomaly rate of VEEG was 59.3%(73/123).The anomaly rate of VEEG was 29.5% (18/61) in mild HIE,82.1% (32/39) in moderate HIE,and 100% (23/23) in severe HIE.The result of VEEG at birth was related to MDI and PDI scores,the worse the VEEG the lower scores of the MDI and PDI.The incidence of sequelae increased significantly in HIE infants with severely abnormal VEEG.Conclusion Neonatal VEEG can reflect the extent of brain damage in infants with HIE.Continuous and multiple monitoring is very valuable in evaluating the prognosis of the infants.

15.
The Journal of Practical Medicine ; (24): 600-603,617, 2018.
Article in Chinese | WPRIM | ID: wpr-697662

ABSTRACT

Objective The intention of this thesis is to present the nervous system symptoms of rare diseases with a view to raising researchers′awareness of these symptoms,providing one of bases for other relevant researches in the future. Methods Based on the classification in Orphanet database,rare neurological diseases are picked out and put into different groups.The diseases with the same neurological symptoms and signs are in the same group. Then,differences and similarities of the diseases in the same group are analyzed. Results 57 kinds of rare neurological diseases are sorted out from rare diseases list and account for 31.49% of total diseases in the list.These diseases are characterized by aspecific,complex and interlaced neurological abnormalities.Specifically, the above-mentioned neurological abnormalities include 10 kinds of neurological symptoms and signs like peripheral neuropathy,epilepsy,and neuromuscular diseases.Conclusions Rare diseases,in most cases,are featured with complex neurological abnormalities,which presents great challenges for identification and diagnosis.In view of this fact,it is helpful to analyze the connection between rare diseases and their symptoms by adopting the classification in Orphanet database,which is beneficial for promoting identification on neurological symptoms and signs of rare diseases.

16.
Article in Chinese | WPRIM | ID: wpr-697620

ABSTRACT

Objective To investigate the experimental effectofmagnetic mNGF nanoparticlesguided by out-side magnetic on the the sciatic nerve injury.Tianjin 300211,China.Methods As a drug carrier,PLGA connects magneticironparticles with and mNGF. The nanoparticle suspension liquid was prepared and its physicochemical properties was characterized. The model of the left sciatic nerve injury in rats was divided into 3 groups. Rats in Group A received intravenous tail vein injectionof magnetic mNGF nanoparticlesfollowed by two-hour outside mag-neticguidance once week.Group B received intravenous tail vein injection of magnetic mNGF nanoparticles without outside magnetic guidance once week. Group C received intravenous tail vein injection of the same content mNGF once week. Two months later,we measured the ischial nerve index(SFI)and madenerve electrical physiological ex-amination under anesthesia.We also measured quality ratio of triceps surae and did left sciatic nerve slice HE stain-ing.Finally,experimental data were statistically analyzed. Results The SFI,nerve conduction velocity and quality ratio of triceps surae of Group A were higher than those of Group B and Group B(P<0.05).There was no significant difference between Group B and Group C(P>0.05).The arrangement and density of the regeneration nerve in Group A were better than those of Group B and C under optical microscope. Conclusion The results showed that the magnetic mNGF nanoparticles guided by outside magnetic can promote the recovery of rat sciatic nerve injury.

17.
Basic & Clinical Medicine ; (12): 62-66, 2017.
Article in Chinese | WPRIM | ID: wpr-509085

ABSTRACT

Objective To explore the correlation of minimal residual disease ( MRD) and ABC genes expression in acute myeloid leukemia ( AML) .Methods 52 de novo AML bone marrow samples were used to detect the expres-sion of ABCB1,ABCC1,ABCC4 andABCG2 by real-time PCR at diagnosis.Meanwhile, followed up these patients to monitor MRD with MFC at the points of finishing the first induction cause as well as the third ,the sixth and the ninth month after chemotherapy .Results The expression level of 4 ABC transporters among three MRD level de-tected after induction cause are correlated significantly with ABCB1(P<0.01), ABCC1(P<0.01), ABCC4(P<0.01) and ABCG2(P<0.01).Further more, after nine months follow-up, the patients whose MRD turned into positive again were detected a high ABC transports expression level , comparing with those MRD remained negative for nine months,which was of a statistically significance for ABCB1(P<0.05), ABCC1(P<0.05), ABCC4(P<0.01) and ABCG2(P<0.01).Conclusions A positive correlation of MRD and ABC transporters level in AML is found.

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Article in English | WPRIM | ID: wpr-349342

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<p><b>INTRODUCTION</b>Minimally invasive surgery (MIS) is increasingly used in the treatment of lumbar stenosis. However, it is still not clear if the employment of minimally invasive surgical techniques can achieve superior clinical outcomes compared to standard open laminectomy.</p><p><b>MATERIALS AND METHODS</b>An extensive literature review regarding the clinical outcome, safety, and efficiency of MIS and standard open surgery (OS) in the treatment of lumbar stenosis was conducted on Medline, Cochrane, EMBASE, and Google Scholar databases up to 19 August 2016.</p><p><b>RESULTS</b>Sixteen studies that enrolled a total of 1580 patients with surgically-indicated lumbar stenosis were identified; 793 patients underwent MIS and 787 patients underwent conventional OS. No significant difference was found in the improvement of Oswestry Disability Index (ODI) (P = 0.718) and operation time (P = 0.322) between patients from different treatment groups. MIS was associated with better visual analogue scale (VAS) for back pain (P = 0.01), shorter length of hospital stay (P <0.001), and lower blood loss (P <0.001).</p><p><b>CONCLUSION</b>Our findings indicate that both MIS and standard OS can effectively manage patients with lumbar stenosis and lead to comparable clinical outcomes. Further studies are necessary to evaluate MIS with different types of conventional surgery for lumbar stenosis.</p>

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Chinese Journal of Trauma ; (12): 724-730, 2017.
Article in Chinese | WPRIM | ID: wpr-609945

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Objective To investigate the related risk factors of the previous cemented vertebral body re-wedge after percutaneous kyphoplasty (PKP).Methods In this retrospective case-control study,clinical data of 617 patients treated by PKP from December 2008 to November 2014 were analyzed.According to whether the cemented vertebra wedged again,the patients were divided into cemented vertebral re-wedge group (n =12) and non-cemented vertebral re-wedge group (n =605).The data of age,preoperative bone density,preoperative vertebral osteonecrosis,intraoperative bone cement injection amount,postoperative bone cement leakage,postoperative bone cement filling,postoperative recovery rate of vertebral wedge angle,and presence or absence of adjacent old vertebral wedging were recorded in two groups.All patients were followed up for one year,and the data were summarized and statistically analyzed.Results Single factor analysis showed the factors of whether there were adjacent old vertebral wedge,preoperative vertebral osteonecrosis,cystic bone cement filling,different wedge angle recovery rate,and emergence of previous cemented vertebral body re-wedge after PKP were statistically significant between two groups (P < 0.05).There was no obvious statistical difference in age,preoperative bone density,intraoperative bone cement injection amount,and intervertebral bone cement leakage between two groups (P > 0.05).Multivariate Logistic stepwise regression analysis showed cystic bone cement filling,preoperative vertebral osteonecrosis,adjacent old vertebral wedging,and higher recovery rate of vertebral wedge angle were prone to appear previous cemented vertebral body rewedge (P < 0.05).Conclusions Relatively higher recovery rate of vertebral wedge angle,previous adjacent old vertebral wedge,vertebral osteonecrosis,and cystic bone cement filling are risk factors closely related to cemented vertebral re-wedge after PKP,which gives a good reference to assess surgical risk,avoid risk factors and choose right surgical techniques.

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Chinese Journal of Urology ; (12): 251-254, 2016.
Article in Chinese | WPRIM | ID: wpr-488696

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Objective To investigate the perioperative outcomes of robot-assisted laparoscopic partial nephrectomy in solitary kidney.Methods From September 2014 to September 2015, 9 patients underwent robot-assisted laparoscopic partial nephrectomy in solitary kidney.6 of these patients were male, while the others were female.The average age of these patients was 60 years, ranged from 46-78 years.The lesion was located in left kidney of 5 cases, and the remaining in right kidney.The average diameter of lesion was 4.5 cm, ranged from 2.8-7.6 cm.One case was congenital solitary kidney, one was contralateral atrophic kidney, 2 cases were performed nephrectomy due to benign lesion, 5 cases were performed radical nephrectomy due to malignancy.All the cases were performed by robot-assisted laparoscopic surgery transperitoneally.Results The surgery of all 9 cases were successfully completed, and no conversion to open surgery.The median operation time was 104-215 min, with an average of 129 min.The estimated blood loss was 50-350 ml, with an average of 120 ml, and there was no blood transfusion.The warm ischemia time was 10-28 min, with an average of 18 min.There was no intraoperative complication occurred.The postoperative length of hospitalization was 8-17 d, with an average of 12 d.One case of urine leakage and another one of secondary hemorrhage were found after operation.The drainage tube and urinary catheter were removed in 3-5 days postoperation.The pathology analysis confirmed that 7 cases were renal clear cell carcinoma, one case was papillary carcinoma and one was angiomyolipoma, the tumor surgical margin was negative in all cases.The follow up duration was 1-12months, no recurrence or metastasis occurred.Conclusions Robot-assisted partial nephrectomy represents a safe and effective minimallyinvasive treatment option for kidney neoplasms in patients with a solitary kidney, which provided reliable cancer control and renal function preservation.

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