Prognosis of traumatic spinal cord injury in children: Follow-up of 86 patients / 中华创伤杂志(英文版)

PURPOSE@#The long-term situation of children with spinal cord injury (SCI) was investigated, and suggestions for helping them better return to the society were provided.@*METHODS@#SCI patients less than 18 years old hospitalized in Beijing Boai Hospital from January 2011 to December 2020 were retrospectively analyzed. Information including motor function, complications, characteristic changes, self-care abilities, school attendance and social participation were collected by telephone interview and electronic questionnaire. All the answers were statistically analyzed.@*RESULTS@#A total of 86 cases were enrolled, 77 girls and 9 boys, with a median injury age of 6 years and 2 months. The follow-up time was 3-130 months. The main cause of trauma in these children was sport injury (66.3%), the thoracic spinal cord was involved the most (91.9%), and complete SCIs accounted for the majority (76.7%). In terms of complications, children with complete SCIs were more likely to have urinary incontinence, constipation and characteristic changes (p < 0.05); whereas the incomplete SCIs often have spasticity (p < 0.05). As to the daily living abilities, children with incomplete lumbar SCIs were more capable to accomplish personal hygiene, transfer, and bathing independently than those with complete injuries, or cervical/thoracic SCIs, respectively (p < 0.05). Moreover, children older than 9 years care more able to dress and transfer independently than the youngers (p < 0.05). Wheelchair users accounted for 84.9% and more than half of them were able to propel wheelchair independently, and those who move passively in wheelchairs were mostly introverted kids (p < 0.05). Almost all (93.8%) children with incomplete injuries were able to walk independently. Most (79.1%) children continued to attending school, and 41.9% participated in interest classes. Unfortunately, 67.4% of the children spent less time playing with their peers than before the injury.@*CONCLUSION@#SCIs impair physical structures and function of children, affect their independence in daily living, and restrict school attendance and social interaction. Comprehensive rehabilitation after injury is a systematic work. Medical staff and caregivers should not only pay attention to neurological function, but also help them improve self-care abilities. It is also important to balance rehabilitation training and school work and social participation.

Application of augmented reality navigation in laparoscopic and robot-assisted liver surgery / 中华外科杂志

In recent years, laparoscopic surgery and robotic surgery have been widely used, and various intraoperative image navigation systems have also developed rapidly. However, the liver itself has a complex vessel and duct system, which increase the difficulty of liver surgery. The augmented reality image navigation system combines the three-dimensional reconstructed image of the liver with the real liver anatomy, which presents the specific relationship between the tumor location and the surrounding vessels for the surgeon. Compared with other intraoperative image navigation methods, augmented reality has its unique advantages. This paper provides an overview of current advances in registration technology in augmented reality image navigation system, and focuses on its applications in liver surgery, including laparoscopic surgery and robotic surgery. Finally, the technological problems and difficulties still faced at present are summarized, and future directions worth studying in this field are proposed.

Advance in Traumatic Pediatric Spinal Cord Injury (review) / 中国康复理论与实践

There are differences in the incidence, causes, mechanisms and prognosis of traumatic spinal cord injury in children between domestic and foreign literatures. Especially in recent years, there are many cases of traumatic spinal cord injury in dance classes in China, which has aroused common concern. This paper reviewed the related literature in recent ten years at home and abroad. It is found that the causes of traumatic spinal cord injury in children abroad are still car accidents and falls, and cervical spine injury is more common. In China, the proportion of spinal injury caused by exercise is increasing, such as back bend dancing movements. Thoracic spinal cord injury is the mostly common. The mechanism of injury includes spinal cord traction and vascular injury. There is still no consensus on the diagnosis, treatment and prognosis of such injuries.

Motor Control Function of Brain in Subacute Complete Spinal Cord Injured Patients: A Functional Magnetic Resonance Imaging Study / 中国康复理论与实践

Objective:To study the changes of brain motor control function in patients with complete spinal cord injury within three to six months. Methods:From January, 2017 to January, 2019, eleven inpatients with complete spinal cord injury and twelve healthy controls were screened with functional magnetic resonance imaging during attempted/executive movement (MA/ME) and motor imagery (MI). The involved area and activation were compared between the groups under tasks. Results:More areas were activated in the patients than in the controls as MA/ME, such as bilateral primary sensorimotor cortex, supplementary motor area, lateral globus pallidus, cerebellum, contralateral thalamus and putamen. During MI, the activation was more in the patients in ipsilateral primary motor cortex, supplementary motor area, dorsal premotor area, contralateral supplementary motor area, insular and basal ganglia. The patients induced more activation as MA than as MI in ipsilateral primary motor cortex, bilateral supplementary motor area and cingulate motor area, and contralateral cerebellum. Conclusion:The activation remains normal in primary motor cortex and supplementary motor area for subacute complete spinal cord injury patients when undergoing motor tasks, but some reorganization may occur in parietal lobe and cerebellum that involve in sensorimotor integration.

Awareness of Autonomic Dysreflexia post Spinal Cord Injury in Surgeons / 中国康复理论与实践

Objective To investigate the levels of knowledge on autonomic dysreflexia (AD) following spinal cord injury (SCI) from surgeons.Methods September 1st to 30th, 71 surgeons from seven departments were tested with the knowledge about AD with a questionnaire.Results Only 35％ of them gave the correct answer above 60％ of the items. The items that got respondence less than 60％ involved in those about causes, clinical signs and symptoms, diagnosis, and treatment for AD. The respondence about knowledge of causes, clinical signs and symptoms, and treatment for AD was different among departments (F＞ 2.270, P ＜ 0.05). The respondence about knowledge of treatment for AD was different among the surgeons who had managed different numbers of SCI patients (F = 4.043, P ＜ 0.05). The knowledge of clinical signs and symptoms, and treatment was different among the surgeons with their self-reported knowledge level of AD (F = 5.519, P ＜ 0.01). There was no difference in knowledge for AD among the surgeons with different educational background, technological position and length of career (F ＜ 2.107, P＞ 0.05).Conclusion The knowledge about AD needs to improve in the surgeons.

Repair effect of Qinbai Qingfei concentrated pellets to AEC-Ⅱ of rats infected by Mycoplasmal pneumonia / 中国中药杂志

To discuss the repair mechanism of Qinbai Qingfei concentrated pellets to AEC-Ⅱ of rats infected by mycoplasma through the observation of the changes and distribution of TGF-β and SP-A in lungs, totally 60 Wistar rats that weighing 80-100 g were collected, with male and female in half. The rats were divided into six groups randomly, with 10 rats each group, namely blank group, model group, positive group and Qinbai Qingfei concentrated pellets high, middle and low dose groups. Rats were infected through nasal intubation drip of MP. After 10 days of administration, serum and bronchoalveolar lavage fluid (BALF) were collected to detect the concentration of surface activity related protein A (SP-A) by ELISA, left pulmonary tissues of rats were collected to observe the expression and distribution of transforming growth factor-beta (TGF-β) and SP-A by immunohistochemistry, and right pulmonary tissues were taken to detect TGF-β and SP-A mRNA expression level by real-time quantitative PCR (RT-PCR). Qinbai Qingfei concentrated pellets can reduce the expression of TGF-β and increase the expression of SP-A in the lung tissues of rats infected by mycoplasma. Specifically, TGF-β was mainly distributed among the lung interstitium, while SPAs were mainly distributed in AEC-II and parts of alveolar macrophage. The level of SP-A was reduced in serum and increased in BALF in rats in Qinbai Qingfei concentrated pellets groups. It was proved that Qinbai Qingfei concentrated pellets can restore the normal morphology and function of the lung by reducing the content of TGF-β to inhibit epithelial-mesenchymal transition (EMT) of alveolar type II epithelial cells and increasing the expression of SP-A. Qinbai Qingfei concentrated pellets have the repairing ability to capillary vessel damage caused by MP in lung tissues of rats.

Focal Nodular Hashimoto's Thyroiditis: Comparison of Ultrasonographic Features with Malignant and Other Benign Nodules

<p><b>INTRODUCTION</b>Hashimoto's thyroiditis (HT) can present as focal nodular disease. This study aimed to determine the distinguishing sonographic features of nodules in biopsy-proven focal HT.</p><p><b>MATERIALS AND METHODS</b>The study included 388 thyroid nodules from 310 patients who underwent ultrasound-guided fine-needle aspiration biopsy (FNAB). There were 28 focal HT, 27 malignant and 333 other benign nodules. Sonographic features of focal HT nodules on prebiopsy ultrasound were compared with malignant nodules and other benign nodules using multinomial logistic regression adjusting for the correlation between multiple nodules obtained from the same patient.</p><p><b>RESULTS</b>Most focal HT nodules were purely solid (92.8%), iso-hyperechoic (70.4%), had regular margins (75.0%) and central vascularity (85.7%). Hypoechogenicity (29.6% vs 42.3%; P = 0.017) and microcalcifications (3.6% vs 44.4%; P = 0.003) were significantly less common in focal HT than malignant nodules. None of the focal HT nodules demonstrated marked hypoechogenicity, irregular margins or cervical lymphadenopathy, which are traditionally associated with malignancy. Compared to other benign nodules, focal HT nodules were significantly more likely to be purely solid (92.8% vs 49.0%; P = 0.016), ill-defined (25.0% vs 7.0%; P = 0.004) and lack comet-tail artefacts (92.9% vs 66.1%; P = 0.012), which in combination were 17.9% sensitive and 94.6% specific for focal HT.</p><p><b>CONCLUSION</b>Awareness of the above-described sonographic appearances of focal HT may aid in differentiating them from malignant nodules and risk-stratify for FNAB. While there is substantial overlap with other benign nodules, a combination of the above-mentioned 3 ultrasound features is highly specific for focal HT and can prompt further serological evaluation in clinically unsuspected HT.</p>

Application of fenestration and suction drainage for treatment of large odontogenic mandibular cystic lesions / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effect of fenestration and suction drainage in the treatment of large odontogenic mandibular cystic lesions.</p><p><b>METHODS</b>From 2005 to 2009, 24 cases of large odontogenic mandibular cystic lesions were treated with fenestration and suction drainage. The clinical symptoms and radiographical findings were evaluated before the operation and at 1 month and 6 months after suction drainage.</p><p><b>RESULTS</b>Follow-up for 1-3 years showed that all the cystic lesions disappeared without recurrence, and the clinical symptoms were resolved.</p><p><b>CONCLUSION</b>Fenestration and suction drainage can reduce the cystic size and rapidly correct the deformity to serve as a useful modality for primary management of large odontogenic mandibular cystic lesions.</p>

Treatment of complex scapular body fractures by locking reconstructive plates / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the method and effect of treatment of complex scapular body fractures by locking reconstructive plate through modified posterior approach.</p><p><b>METHODS</b>From August 2005 to November 2009, 27 patients with complex scapula body fractures were treated by locking reconstruction bone plate fixation,including 19 males and 8 females with an average age of 36 years old ranging from 16 to 64 years. The time after injury was 0.5 hours to 11 days (averaged 3 days). Of all the patients, 9 cases were associated with ipsilateral clavicle fracture, 2 cases were associated with acromioclavicular joint dislocation,16 cases were associated with multiple rib fractures, 1 case were associated with humeral shaft fractures, 5 cases were associated with pleural effusion, atelectasis, lung contusion etc. After operating,shoulder functional recovery were followed up.</p><p><b>RESULTS</b>Twenty-four patients were followed up from 2 to 35 months with an average of 19 months. According to Hardegger shoulder function,the results were excellent in 15 cases, good in 7 cases, general in 2 cases.</p><p><b>CONCLUSION</b>This method had the advantage of less trauma and clear exposure, firm and reliable fixation, and early activities.</p>

Using tension-band laminoplasty as a management for cervical ossification of posterior longitudinal ligament / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effectiveness of Tension-band Laminoplasty (TBL) as a management for cervical ossification of posterior longitudinal ligament (OPLL).</p><p><b>METHODS</b>Forty-six patients with cervical OPLL and undergone TBL in our department were chosen for the present study, including 33 male and 13 female. The mean age was 59 years (36 - 77 years). These OPLLs were confirmed as following types: 4 cases of single spinal level, 20 cases of continuous and 22 cases of mixed type. C(3) or/and C(2) levels were involved in 16 cases. All the patients underwent C(2 - 7) TBL, to which C(1) laminectomy was added for the cases with C(3) and/or C(2) involved. The neurological effect was evaluated by using Japanese Orthopedic Association (JOA) scoring criteria for cervical myelopathy. The anatomical effect was analyzed by comparing the pre- and post-operatively roentgenograms and MRIs. Wilcoxon's rank test was used for the statistics study.</p><p><b>RESULTS</b>For 42 (91.3%) patients, the JOA scores were improved for approximately 2 points after the operation, posterior shift of the spinal cord was obtained, while the diameters of dural sleeves and spinal cords were enlarged, yet the spinal alignments were not significantly interrupted.</p><p><b>CONCLUSIONS</b>TBL was proved an effective treatment for cervical OPLL and it could be expanded to include C(1) laminectomy if the spinal levels upper than C(4) were involved.</p>

Clinical Characteristics and Treatment Choices of Cervical Vertebrae Injury in the Elderly / 中国康复理论与实践

@# Objective To summarize clinical characteristics and treatment methods of cervical vertebrae injury in the elderly.MethodsThe data of 59 elderly patients with cervical vertebrae injury from 2002 to 2006 years were retrospectively reviewed.ResultsThe most common type of injuries was hyperextension injuries of cervical spine and cervial central cord syndrome.Traffic accident and falling injury were the most common reasons.Early operation and early rehabilitation could improve the ASIA 1 or 2 grade,and avoid complications of cord injury effectively.ConclusionThe key treatment point of cervical vertebrae injury in the elderly is how to get them leave bed in order to reduce the complications of cord injury,early operation and rehabilitation are good method to decrease the mortality and increase quality of life.

Clinical Characteristics and Treatment Choices of Cervical Vertebrae Injury in the Elderly / 中国康复理论与实践

@#Objective To summarize clinical characteristics and treatment methods of cervical vertebrae injury in the elderly.MethodsThe data of 59 elderly patients with cervical vertebrae injury from 2002 to 2006 years were retrospectively reviewed.ResultsThe most common type of injuries was hyperextension injuries of cervical spine and cervial central cord syndrome.Traffic accident and falling injury were the most common reasons.Early operation and early rehabilitation could improve the ASIA 1 or 2 grade,and avoid complications of cord injury effectively.ConclusionThe key treatment point of cervical vertebrae injury in the elderly is how to get them leave bed in order to reduce the complications of cord injury,early operation and rehabilitation are good method to decrease the mortality and increase quality of life.