Effects of acupuncture, combined with phacoemulsification for cataract with glaucoma / 中国针灸

OBJECTIVE@#To observe the effects of acupuncture combined with phacoemulsification for cataract with glaucoma.@*METHODS@#Sixty-eight patients with cataract and angle-closure glaucoma were randomly divided into an observation group and a control group, 34 cases in each one. The patients in the control group were treated with phacoemulsification. Based on the treatment in the control group, the patients in the observation group were treated with and acupuncture at acupoints around eyes; the treatment was given once every other day, and 15-day treatment constituted a course, and 2 courses (60 days) were given. The intraocular pressure (IOP), visual acuity, pain severity, aqueous outflow (F value) and clinical symptoms were observed in the two groups before treatment and after 1 d, 7 d, 30 d and 60 d of treatment.@*RESULTS@#The IOP after 1 d, 7 d, 30 d and 60 d of treatment in the observation group was lower than that in the control group (all <0.05), while the visual acuity after 7 d, 30 d and 60 d of treatment in the observation group was higher than that in the control group (all <0.05). Compared before treatment, the IOP was significantly decreased after 1 d, 7 d, 30 d and 60 d of treatment in the two groups, and the visual acuity was significantly increased after 7 d, 30 d and 60 d of treatment in the two groups (all <0.05). The pain scores and F value after 7 d, 30 d and 60 d of treatment in the observation group were lower than those in the control group (all <0.05). Compared before treatment, the pain scores and F value after 7 d, 30 d and 60 d of treatment were significantly reduced in the two groups (all <0.05). After 60 d of treatment, the number of patients who presented general clinical symptoms in the observation group was significantly lower than that in the control group (<0.05).@*CONCLUSION@#Based on phacoemulsification, acupuncture and could significantly reduce the IOP and F value, relieve pain and improve visual acuity in patients with cataract and glaucoma.

Minimum 2-Year Experience with Magnetically Controlled Growing Rods for the Treatment of Early-Onset Scoliosis: A Systematic Review

Magnetically controlled growing rods have been used to treat early-onset scoliosis for the last 9 years; however, few studies have been published, with only short-term follow-up. The aim of the present study is to systematically review the outcomes of magnetically controlled growing rods in the treatment of early-onset scoliosis with a minimum of 2-year follow-up. Studies were included if patients with early-onset scoliosis (scoliosis diagnosed before 10 years of age) underwent implantation of magnetically controlled growing rods with a minimum of 2-year follow-up. The literature review and data extraction followed the established preferred reporting items for systematic review and meta-analysis guidelines. Data of distraction frequency, number of distractions, distracted length, Cobb angle, kyphosis, T1–T12 length, and T1–S1 length preoperatively, postoperatively, and at final follow-up were collected. Data regarding complications and unplanned reoperations were also extracted. The mean values of these parameters were calculated, or pooled meta-analysis was performed if available. Ten articles were included in this systematic review, with a total of 116 patients and a follow-up period between 23 and 61 months. The mean preoperative Cobb angle and kyphosis angle were 60.1° and 38.0°, respectively, and improved to 35.4° and 26.1° postoperatively. At final follow-up, the Cobb and kyphosis angles were maintained at 36.9° and 36.0°, respectively. The average preoperative T1–T12 and T1–S1 lengths were 180.6 mm and 293.6 mm, respectively, and increased to 198.3 mm and 320.3 mm postoperatively. T1–T12 and T1–S1 lengths were 212.3 mm and 339.3 mm at final follow-up, respectively. The overall rate of patients with complications was 48% (95% confidence interval [CI], 0.38–0.58) and unplanned reoperation 44% (95% CI, 0.33–0.55) after sensitivity analysis. The current evidence from different countries with a minimum of a 2-year follow-up suggests that magnetically controlled growing rods are an effective technique to treat pediatric scoliosis and promote spine growth. However, nearly half of patients still developed complications or required unplanned reoperations.

Characteristics of tidal breathing pulmonary function in children with tracheobronchomalacia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the characteristics of tidal breathing pulmonary function in children with tracheobronchomalacia (TBM).</p><p><b>METHODS</b>In this study, 30 children who were diagnosed with TBM using electronic bronchoscopy were enrolled in the observation group; 30 healthy children were recruited in the normal control group. For individuals in each group, the assessment of tidal breath pulmonary function was performed at diagnosis and 3, 6, 9, and 12 months after diagnosis.</p><p><b>RESULTS</b>There were no significant differences in tidal volume, inspiratory time, expiratory time, and inspiratory to expiratory ratio between the two groups (P>0.05). Compared with the control group, the observation group had a significantly higher respiratory rate and significantly lower ratio of time to peak tidal expiratory flow to total expiratory time (TPTEF/TE) and ratio of volume to peak tidal expiratory flow to total expiratory volume (VPTEF/VE). There was a time-dependent increase in TPTEF/TE and VPTEF/VE for TBM children from the time of initial diagnosis to 12 months after diagnosis.</p><p><b>CONCLUSIONS</b>Tidal breathing pulmonary function has characteristic changes in children with TBM. Tidal breathing pulmonary function tends to be recovered with increased age in children with TBM.</p>

The Surgical Management of Traumatic Lower Cervical Spondylolisthesis with Posterior Percutaneous Pedicle Screw Fixation

We reported a technical report of traumatic lower cervical spondylolisthesisca used by bilateral pedicle fracture, without neurological compression. The patient was treated with the minimally invasive technique of percutaneous pedicle screw fixation. Fracture healing and normal cervical motion were confirmed by plain films and physical examinations on the 18-monthpostoperatively. The technique of percutaneous pedicle screw fixation might be an alternative strategy for the treatment of traumatic lower cervical spondylolisthesis with pedicle fracture.

Biomechanical characteristics analysis on discs with coflex fixation on the different segments of lower lumbar spine / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the biomechanical differences between the surgery and adjacent segments of intervertebral discs in the lower lumbar spine, which were implanted with Coflex into the segments of L4, and L5S1, respectively.</p><p><b>METHODS</b>Three finite-element models (the model of the intact lower lumbar sacrum,the L4.5 and L5S1 segments implanted by Coflex) were developed, respectively. According to the spinal three-column loading theory, three models were forced by the physiological loads of upright standing, flexion and extension. The stress of the different areas of the disc annulus, the changes of intervertebral dorsal height and the degree of nucleus pulposus pressure were compared and analyzed.</p><p><b>RESULTS</b>Coflex implanted into the L4.5 and L5S1 segments in compression and extension could both decrease the stress of the posterior area of intervertebral disc in the surgery segment, resist the changes of the intervertebral disc dorsal height and reduce the perssure of nucleus pulposus. Furthermore, the stress of the L5S1 segment decreased when Coflex fixed the L4.5 segment in extension. However, when Coflex fixed the L5S1 segment, the stress of L4.5 segment had no significant changes.</p><p><b>CONCLUSION</b>Coflex fixing the L4,5 and L5S1 segments can effectively decrease the stress of the surgery segmental discs, respectively. Furthermore, Coflex fixing L4,5 segment may play a biomechanical role in reducing the stress of L5S1 segment.</p>

Effects of sublingual immunotherapy on serum IL-17 and IL-35 levels in children with allergic rhinitis or asthma / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical effect and mechanisms of specific sublingual immunotherapy (SLIT) for the treatment of allergic rhinitis or asthma in children.</p><p><b>METHODS</b>Thirty children suffering from Dermatophagoides farinae-allergic rhinitis or asthma (case group) and 30 healthy children (control group) were enrolled in this study. The case group accepted SLIT between January and December 2011. The ratio of forced expiratory volume in one second (FEV1) and its expected value, the ratio of airway resistance and its expected value, peripheral blood eosinophil (Eos) count and serum levels of IL-17 and IL-35 were measured before treatment and one and two years after treatment. The rhinitis or asthma symptom scores were rated and the level of asthma control was monitored.</p><p><b>RESULTS</b>Serum IL-17 level in the case group was significantly higher than in the control group before treatment and one year after treatment (P<0.01). Furthermore, serum IL-17 level in the case group gradually decreased from before treatment to 1 year to 2 years after treatment (P<0.01). By two years of treatment, there was no significant difference in serum IL-17 level between the case and control groups (P>0.05). The changes of serum IL-35 level after treatment were opposite to serum IL-17 in the case group. The ratio of FEV1 and its expected value gradually increased from before treatment to 1 year to 2 years after treatment (P<0.01) in the case group. In contrast, the change of the ratio of airway resistance and its expected value and Eos count gradually decreased from before treatment to 1 year to 2 years after treatment (P<0.01) in the case group. More patients achieved improved rhinitis or asthma symptom scores two years after treatment than one year after treatment in the case group (P<0.01). SLIT was effective in 85% of children with allergic rhinitis one after treatment vs 100% two years after treatment. Asthma control was observed in 76% of the asthmatic patients one after treatment vs 92% two years after treatment.</p><p><b>CONCLUSIONS</b>SLIT is effective for allergic rhinitis and asthma in children, and the treatment period of two years seems to be superior to one year. The mechanism of action of SLIT for the treatment of allergic rhinitis and asthma may be associated with inhibition of IL-17 expression and promotion of IL-35 expression.</p>

Finite element model testing on Coflex dynamic fixation for L4/5 and L5/S1 segment of lower lumbar / 医用生物力学

Objective To simulate clinical operation and investigate feasibility of Coflex dynamic device for fixing L5/S1 segment of lower lumbar degenerative diseases. Methods The lower lumbar-sacral digital model was extracted from platform of the second generation of Chinese Digitized Human “Male No.23” data set, and three finite element (FE) models (the model of normal lower lumbar sacrum, L4/5 and L5/S1 segment fixed with Coflex) were developed respectively using a series of CAX software. According to the spinal three-column loading theory and the lower lumbar physiological behaviors, FE model tests were analyzed, validated and compared under the physiological load of upright standing, anteflexion and extension. Results The FE models of normal lower lumbar sacrum (Healthy), Coflex fixed-L4/5 segment (L4/5), Coflex fixed-L5/S1 segment (L5/S1) were developed, respectively. Based on biomechanical indexes (stability and compatibility) of the controlled trial for the FE model, the two Coflex-fixed FE models showed similar biomechanical effects for fixing the lower lumbar. Conclusions The controlled trials of FE models provide biomechanical evidence for the fixation of lower lumbar L5/S1 segment by Coflex dynamic device, which is of significance for application of Coflex in fixing L5/S1 segment in clinic.

Relative risk factors influencing severity of leukoaraiosis in patients with type 2 diabetes / 中华神经医学杂志

Objective To investigate the relationships between the risk factors (the levels of blood glucose and blood fat) and the severity of leukoaraiosis (LA) in patients with type 2 diabetes.Methods The risk factors (including levels of plasma HbA1c,fasting blood glucose,2 hours blood glucose after meals,triglyceride,total cholesterol,high density lipoprotein,and low density lipoprotein) were measured and the head magnetic resonance were used in the selected patients who were diagnosed as having subcortical vascular dementia and type 2 diabetes (n=106).According to the Fazekas's classification of signals of deep white matter hyperintense (DWMH) and periventricular hyperintense (PVH),the severity of LA was graded as grade 1,2 and 3 by its appearance under MRI.LA scores were obtained by its appearance under MRI according to the semiquantitative way; the influencing factors of LA scores were analyzed using multiple linear regression.The clinical features of patients with different plasma HbAlc levels were compared; the relations of signals of DWMH and PVH with other risk factors were compared; and the clinical features of patients with different signals of DWMH and PVH were compared too.Results LA scores were positively related to HbAlc level and age (r=0.457,P=0.000;r=0.400,P=0.000).The signals of DWMH and PVH were positively related to the HbA1c level and age (r=0.385,P=0.000; r=0.361,P=0.000; r=0.458,P=0.000; r=0.364,P=0.000).Statistical significance of stroke history in different signals of DWMH and PVH was noted (P＜0.05).After adjusting the age,signals of DWMH and PVH were positively correlated to the HbA1c level (r=0.253,P=0.009; r=0.318,P=0.001).Conclusion In the patients with type 2 diabetes,the plasma level of HbA 1 c is an important biochemical indicator which reflects the severity of LA (including DWMH and PVH); age and stroke history are relative with the severity of LA,while blood fat level is not correlated to the severity of LA.

Clinical differences of ischemic stroke related to lenticulostriate arteries and paramedian pontine arteries caused by intracranial branch atheromatous diseases / 中华神经医学杂志

Objective To investigate the clinical differences and the mechanism of ischemic stroke related to intracranial branch atheromatous diseases.Methods All 213 consecutive patients diagnosed with ischemic stroke related to intracranial branch atheromatous diseases by using diffusion-weighted imaging (DWI),admitted to our hospital from January 22,2008 to October 13,2011,were studied.These patients were classified into paramedian pontine arteries group (PPA group,n=56)and lenticulostriate arteries group (LSA group,n=157) according to the DWI findings.The clinical characteristics were compared between the two groups.Results The differences on the mean length of hospital stay and white matter degeneration were statistically significant between PPA group and LSA group (t=-2.044,P=0.045; x2=6.832,P=0.009).In univariate logistic regression analysis,the odds ratio (OR) of concomitant white matter degeneration comparing with the opposite was 11.652,95％CI was (1.483-91.529) and P value was 0.020.Conclusion The ischemic stroke related to intracranial branch atheromatous diseases usually accompanies with concomitant white matter degeneration,and the characteristics are different resulting from different blood supplies.

Different features of deep gray matter lesions on MRI among acute disseminated encephalomyelitis, multiple sclerosis, and neuromyelitis optica in adults / 中华神经医学杂志

Objective To find out the different features of deep gray matter lesions on magnetic resonance imaging (MRI) among patients with acute disseminated encephalomyelitis (ADEM),multiple sclerosis (MS),and neuromyelitis optica (NMO) in adults.Methods After searching the database,353 adult patients,admitted to our hospital from August 2004 to October 2012 and diagnosed as ADEM,MS,and NMO,were identified.Among them,95 adult patients with ADEM (n=12),MS (n=60) and NMO (n=23) had deep gray matter lesions on MRI were included in our study.Morphological features of deep gray matter lesions,including diameter,quantity and distribution among these patients,were compared.Results The percentage of lesions involved in the thalamus,caudate nucleus and globus pallidus was not significantly different among the three groups (P＞0.05).Putamen was more frequently involved in patients with ADEM than that in patients with MS and NMO (P=0.002 and 0.013,respectively).Hypothalamus was more frequently involved in patients with NMO than that in patients with ADEM and MS (P=0.033 and 0.001,respectively).The diameter of the thalamus lesion in patients with ADEM was significantly larger than that in patients with NMO (P=0.027),but was not significantly different from that in patients with MS (P=0.116); no significant difference between the lesion diameters of patients with MS and NMO was observed (P=0.209).The diameters of the lesions located in the caudate nucleus,globuspallidus,putmen,and hypothalamus were not significantly different among the three groups (P＞0.05).Furthermore,no significant difference was found among the three groups in respect of the symmetry of lesion distribution (P=0.335).Conclusions Thalamus involvement might not be helpful in differentiating ADEM from MS in adults.Putamen involvement might be helpful in differentiating ADEM from MS and NMO.Hypothalamus involvement is specific for NMO.Lesion size is not useful in the differential diagnosis of ADEM,MS,and NMO.

Vertebral Compression Fracture with Intravertebral Vacuum Cleft Sign: Pathogenesis, Image, and Surgical Intervention

The intravertebral vacuum cleft (IVC) sign in vertebral compression fracture patients has obtained much attention. The pathogenesis, image character and efficacy of surgical intervention were disputed. Many pathogenesis theories were proposed, and its image characters are distinct from malignancy and infection. Percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) have been the main therapeutic methods for these patients in recent years. Avascular necrosis theory is the most supported; PVP could relieve back pain, restore vertebral body height and correct the kyphotic angulation (KA), and is recommended for these patients. PKP seems to be more effective for the correction of KA and lower cement leakage. The Kummell's disease with IVC sign reported by modern authors was incomplete consistent with syndrome reported by Dr. Hermann Kummell.

Successful short-segment fixation for thoracolumbar burst fractures using CYL-pedicle screw / 中华外科杂志

<p><b>OBJECTIVE</b>To access the efficacy of posterior short-segment fixation for single level thoracolumbar burst fractures without spinal injury using CYL-pedicle screw.</p><p><b>METHODS</b>From September 2007 to December 2009, 74 cases who underwent posterior short-segment fixation for single level thoracolumbar burst fractures (Denis burst fracture type A, B, C) without spinal injury were analyzed retrospectively. There were 53 male and 21 female, mean age was (39 ± 15) years. Neither of them treated with direct decompression, grafting or fusion. Changes in the anterior vertebral height ratio, vertebral wedge angle, Cobb angle, regional angle were measured preoperatively, postoperatively, before implant removal, and at final follow-up to find the statistic difference. Pain status and work status were evaluated using Denis criterion. The incidence of incision infection, screw breakage, iatrogenic spinal injury were recorded as well.</p><p><b>RESULTS</b>The time of follow-up was (20 ± 11) months, no significant change was noted in anterior vertebral height ratio and vertebral wedge angle (P > 0.05). A significant loss was noted in Cobb angle and regional angle, which were 9.8° ± 5.1° and 9.1° ± 4.8° respectively (t = 2.48 and 3.41, P < 0.05). Comparing with the patients with Cobb angle > 20°, the patients with Cobb angle ≤ 20° had better pain scale rate (χ(2) = 4.16, P = 0.04) and work scale rate (χ(2) = 24.34, P < 0.01). There were incision infection in 1 case, screw breakage in 1, screw loose in 1, and no iatrogenic spinal injury.</p><p><b>CONCLUSIONS</b>CYL-pedicle screw could be successfully used in posterior short-segment fixation for single level thoracolumbar burst fractures without spinal injury based on radiographic and clinic outcomes.</p>

Application of bacterial cultures of bronchoalveolar lavage fluids in children with pulmonary infection / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the value of bacterial cultures of bronchoalveolar lavage fluids (BALF) in children with pulmonary infection.</p><p><b>METHODS</b>Bacterial cultures sampled from both sputum and BALF were performed on 80 hospitalized children with pulmonary infection between June 2008 and February 2011.Culture results between the two samples were compared.</p><p><b>RESULTS</b>In the 80 children with pulmonary infection, bacterial cultures of BALF showed that Viridans Streptococci were found in 72 cases (90%), Neisseria in 41 cases (51%), Streptococcus pneumoniae in 11 cases (14%), Staphylococcus Aureus in 3 cases (4%) and Escherichia coli in 3 cases (4%). The positive rates of Viridans Streptococci in the bacterial cultures of BALF was not significantly different from the bacterial cultures of sputum, but the positive rate of Streptococcus pneumoniae in the bacterial cultures of BALF was significantly higher than in the bacterial cultures of sputum (4%). Moreover, Escherichia coli were found only by bacterial cultures of BALF.</p><p><b>CONCLUSIONS</b>Bacterial cultures of BALF are useful in the identification of pathogenic bacteria for pulmonary infection in children. Due to the samples taken from the lesion regions in bacterial cultures of BALF, the results of may be more reliable.</p>

Correlation between severity of leukoaraiosis and plasma levels of homocysteine and fibrinogen in patients with Binswanger disease / 中华神经医学杂志

Objective To investigate the correlation between severity of leukoaraiosis (LA) and plasma levels of homocysteine and fibrinogen in patients with Binswanger disease (BD).Methods All patients with BD,admitted to our hospital from January 2005 to May 2011,were selected consistently with the diagnostic criteria of Bennett.The levels of plasma homocysteine (Hcy),fibrinogen (Hcy),low-density lipoprotein (LDL),apolipoprotein A (Apoa),apolipoprotein B (Apob),and high-density lipoprotein (HDL) were measured.According to the Kinkel's classification of BD,the severity of LA was graded as mild,moderate,or severe by its appearance under MRI.The relation between levels of plasma Hcy and Fib and severity of LA in BD patients were analyzed.Results Single factor analysis indicated that the dispositions of gender,age,hypertensive disease,stroke and hyperlipoidemia in BD patients with different severities of LA were significantly different (P＜0.05).The severity degree of LA was positively correlated with the levels of Hcy and Fib (P＜0.05).Ordered logistic regression analysis showed that female was severer than male in the severity of the LA in BD patients; age,stroke and level of plasma Fib were positively related to the severity of LA in BD patients (P＜0.05).Conclusion The high plasma level of Fib is an important factor for BD deterioration; reducing the level of plasma Fib may delay the aggravation of BD.

Relationship between Rhinovirus Infection and Asthma in Children / 实用儿科临床杂志

Objective To explore the correlation of rhinovirus infection and the morbidity of asthma in children.Methods The RV gene in nasopharyngeal secretion of 30 children with asthma acute exacerbation(asthma group),30 children in asthma clinical remission(remission group) and 30 healthy children (control group) were detected by reverse transcription-polymerase chain reaction(RT-PCR).The total serum IgE(T-IgE) was determined by chemiluminescence.The eosinophil(EOS) count (EOS%) of peripheral blood and lung function were also measured.Results The rhinovirus infection rate was 36.67% in asthma group and 3.33% in remission group.No rhinovirus was detected in control group.The rate of rhinovirus infections in asthma group was significantly highter than that in remission group and control group(?2=7.50,13.47 Pa0.05). FEV1% was (62.73?13.54)% in asthma rhinovirus infection and (86.42?17.78)% masthma with no rhinovirus infection.There was remarkable difference between 2 groups(F=14.553 P﹤0.05). The T-IgE was (836.32?44.801) kU/L and EOS% was 10.63?4.09 in asthma group with rhinovirus infection.The total IgE was (439.10?231.28) kU/L and EOS% was 5.04?2.64 in asthma group with no rhinovirus infection.There was significant difference between 2 groups(U=2.475,F=20.806 Pa0.05).Conclusions There is a close correlation between rhinovirus infection and acute attack of asthma(or worsening asthma) in children. Asthma exacerbations would be likely to happened easier because of rhinovirus infection in asthmatic children with high T-IgE.