Changes of thickness and area of ligamenta flavum after lateral lumbar interbody fusion / 中华骨科杂志

Objective:To investigate the changes of thickness and area of the ligamentum flavum after lateral lumbar interbody fusion (LLIF) for lumbar degenerative diseases.Methods:From 2019 to 2021, a total of 54 patients with lumbar degenerative diseases who underwent LLIF combined with percutaneous pedicle screw internal fixation were retrospectively analyzed. There were 9 males and 45 females, aged 59.46±6.91 years (range, 45-76 years), followed up for 14.69±6.87 months (range, 12-33 months). The disc height (DH), midsagittal canal diameter (CD), dural sac axial cross-sectional area (DCSA), ligamentum flavum area (LFA) and ligamentum flavum thickness (LFT) before and after surgery and at the last follow-up were evaluated and compared. Pearson correlation analysis was used to assess the relationship between the amount of change in the DCSA and LFA in the immediate postoperative period and at the last follow-up, as well as the correlation between the two and the amount of change in the DH. The data of patients at the last follow-up of 12 months after operation were extracted. Pearson correlation was used to evaluate the changes in DCSA and LFA at the last follow-up and the visual analogue scale (VAS) of low back pain and leg pain and Oswestry disability index (ODI) at 1 year after surgery.Results:All patients were followed up for 14.69±6.87 months (range, 12-33 months). The differences in DH ( F=354.93, P<0.001), sagittal CD ( F=44.78, P<0.001) and DCSA ( F=130.97, P<0.001) before, immediately after surgery and at the last follow-up were statistically significant. The DH, sagittal CD, and DCSA immediate after surgery and last follow-up were higher than those before surgery ( P<0.05). The differences in LFA ( F=51.59, P<0.001) and bilateral LFT ( F=53.49, P<0.001; F=50.53, P<0.001) before and after surgery and at the last follow-up were statistically significant, and both LFA and bilateral LFT at immediate after surgery and last follow-up were smaller than those before surgery ( P<0.05). Pearson correlation analysis showed that the change of DH immediately after surgery was moderately correlated with the change of DCSA ( r=0.57, P<0.001), and was strongly correlated with the change of LFA ( r=0.65, P<0.001). The change of DH at the last follow-up was moderately correlated with the change of DCSA ( r=0.43, P<0.001), and was weakly correlated with the change of LFA ( r=0.25, P=0.042). The differences in VAS-leg ( F=199.51, P<0.001), VAS-low back ( F=233.90, P<0.001), and ODI ( F=199.17, P<0.001) were statistically significant in patients before operation, 3 months after operation and 12 months after operation. There was no correlation between the changes of DCSA and LFA at the last follow-up and the changes of VAS and ODI at 1 year after operation ( P>0.05). Conclusion:LFA and LFT decrease and DCSA increase in patients with lumbar degenerative diseases after LLIF. LFA and LFT gradually decrease with time, and VAS and ODI are significantly improved compared with those before surgery. The DH loss caused by a certain degree of cage subsidence after surgery does not affect the clinical efficacy. There is no correlation between the improvement of DCSA and LFA and the improvement of clinical symptoms.

Research progress of Chinese medicine treatment for chest contusion / 国际中医中药杂志

Chest contusion is the soft-tissue injury disorders that the external violence directly destroys the chest wall and the soft tissues, causing chest pain, fullness, and symptoms aggravate when the chest moves. Chinese medicine showed many treatments with clinical efficacy. Therefore, Chinese medicine has been widely used in clinics. This paper was to review the research progress of Chinese medicine treatment for chest contusion.

Initial study on the incidence of colorectal diseases in 719 patients with chronic kidney disease / 中华消化杂志

Objective To investigate the incidence of colorectal disease in patients with chronic kidney disease (CKD) and analyze the risk factor of colorectal disease in patients with CKD.Methods The clinical data of 719 patients with CKD underwent colonoscopy examination and 404 patients without CKD underwent colonoscopy examination were collected.The incidence of colorectal disease was compared between patients of the two groups.According to the results of colonoscopy examination,the patients with CKD were divided into colonoscopy positive group and negative group,and clinical biochemical indexes of the two groups were analyzed.The rank-sum test or t-test was used to compare the measurement data.Rates were compared by Chi-square test.The risk factors of colorectal disease in patients with CKD were evaluated by logistic regression.Results The positive rate of colonoscopy examination in 719 patients with CKD was 21.28％ (153/719),which was higher than that of patients without CKD (12.62 ％,51/404; x2 =13.036,P＜0.01).The positive rate of colonoscopy in patients with CKD at stage 1 was 17.50％ (56/320),at stage 2 or 3 was 22.68％(66/291),at stage 4 or 5 was 28.70％ (31/108).There were significant differences among the three groups (x2-6.623,P＜0.05).The incidence of colorectal cancer in patients with CKD was 3.89 ％ (28/719),which was higher than that of patients without CKD (1.73％,7/404; x2 =4.003,P＜0.05).The incidence of colorectal polyps in CKD group was 8.34％(60/719),which was higher than that of non-CKD group (5.20％,21/404; x2 =3.827,P＜0.05).The incidence of inflammatory bowel disease in CKD group was 9.04％(65/719),which was higher than that of non-CKD group (5.69 ％,23/404; x2 =4.013,P＜0.05).The incidence of colorectal cancer and colorectal polyps in patients with CKD at stage Ⅰ was 2.50％(8/320) and 6.25％(20/320),at stage 2 or 3 was 3.78％(11/291) and 8.59％(25/291),at stage 4 or 5 was 8.33％(9/108) and 13.89％ (15/108).There were significant differences among the three groups (x2-7.359 and 6.199,both P＜ 0.05).The age of colonoscopy positive group was older than that of colonoscopy negative group (t=-3.821,P＜0.01); there were lower hemoglobin (t=3.541,P＜0.01),increased erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) (Z=-4.996 and-7.493,both P＜0.01),higher cholesterol and low density lipoprotein (t=-2.659 and-3.248,both P＜0.01),increased serum creatinine (Z=-3.683,P＜0.01) and declined glomerular filtration rate (Z=-6.227,P＜0.01) in colonoscopy positive group than in colonoscopy negative group; the differences were statistically significant.Logistic regression analysis indicated that age (β=0.981,95％ CI 0.965 to 0.998,P =0.032),serum creatinine (β=1.006,95％CI 1.002 to 1.009,P=0.001) and ESR (β=1.029,95％CI 1.018 to 1.040,P＜0.01) were risk factors of colorectal disease in patients with CKD.Conclusions The incidence of colorectal disease in patients with CKD is high,and it increases along with the declined glomerular filtration rate.The colorectal disease in patients with CKD patients may be associated with age,anemia,lipid metabolism,inflammation and impaired renal function.

Core decompression combined with autologous concentrated bone marrow cell transplantation for treatment of early osteonecrosis of femoral head / 重庆医学

Objective To observe the clinical outcome of core decompression combined with autologous concentrated bone mar‐row cell transplantation for treatment of early osteonecrosis of femoral head .Methods Forty six patients (82 hips) included in this retrospective analysis were divided into observation group (30 cases ,44 hips) and the control group (26 cases ,38 hips) .The obser‐vation group were treated by autologous BMMSCs transplantation joint core decompression treatment while control group treated only with core decompression .The therapeutic effect of 2 methods of treatment were summarized by comparing the 2 groups after 3 ,6 ,18 months postoperative with Harris hip score and the imaging changes and necrosis area percentage change degree at 18 months postoperatively .Results The Harris scores of the observation group after operation increased significantly [(88 .24 ± 5 .53) score] ,the excellent and good rate was 84 .09% ;the Harris scores of the control group after operation increased significantly [(75 .48 ± 4 .20)% ] ,the excellent and good rate was 71 .05% ;MRI necrosis area of the observation group after operation reduced gradually[(13 .86 ± 4 .27)% ] and the MRI necrosis area of the control group after operation reduced gradually [(19 .53 ± 5 .29)% ] .There was significant difference between them (P<0 .05) .Harris scores and the imaging changes and necrosis area per‐centage change degree of both group had been improved after the operation (P<0 .05) .Conclusion The core decompression com‐bined with autologous concentrated bone marrow cell transplantation for treatment of early osteonecrosis clinical efficacy might be better than core decompression .

Imageology Study of Icariin in Promoting Regenerate Ossification During Distraction Osteogenesis in Rabbits with Femur Bone Defect / 广州中医药大学学报

Objective To establish the model of distraction osteogenesis for rabbit femur bone defect, and to observe the effect of icariin on regenerate ossification after distraction osteogenesis, thus to find a method for promoting regenerate ossification after distraction osteogenesis. Methods After the rabbit model of bone defect had been established successfully, the rabbits were equipped with distraction device. And then the 24 modeled rab bits were randomly divided into 2 groups. The experimental group was injected with icariin extract of Herba Epimedii into the interspace of bone distraction, and the control group was given local injection of recombinant human bone morphogenetic protein-2 (rhBMP-2, 100μg/kg) . On week 0, 1, 4 and 6 after the resting period, X-ray photography was carried out in both groups. On week 6 after distraction osteogenesis, the bone specimens of distraction osteogenesis region in both groups were observed by micro-computerized tomography ( CT) for the comparison of bone mass, and bone mineral content and mineral density of the newly-formed bone. Results The results of the features of imageology, and the statistical data of the bone mineral content and density showed that osteogenesis speed and osteogenic quality of the experimental group were superior to those of the control group. Conclusion The rabbit model of distraction osteogenesis for femur bone defect has been established preliminarily, and icariin can promote the speed and quality of regenerate ossification after distraction osteogenesis.

Diagnostic value of sound velocity and real-time ultrasonic elastographpy in differentiation benign or malignant of breast lesions / 中华超声影像学杂志

Objective To compare the diagnostic value of sound velocity(SV) and real-time ultrasonic elastography in differentiating benign or malignant of breast lesions.Methods 75 patients with 99 lesions were examined with the zone speed index technique and real-time ultrasonic elastography respectively.Then the SVs of the lesions were calculated and elastography of the lesions were scored with 5-scoring method.The ROC curves were constructed with histology as the golden standard.Results There was significant difference between the SVs of benign and malignant breast lesions(P =0.0001).1561 m/s was the best cufoff point.And the areas under the curves (AUC) of SV and real-time ultrasonic elastography were 0.842 and 0.968,respectively.There was significant difference between the two methods of AUC (P =0.023).The sensitivity,specificity and accuracy for SV were 81.5％,91.7％,88.9％,respectively.There was no significant difference between sensitivity,specificity and accuracy of the two methods(P =1.0,P =0.125,P =0.146).Conclusions Both SV method and real-time ultrasonic elastography are helpful in the evaluation of benign or malignant of breast lesions.

Initial study of contrast-enhanced ultrasound 5-point scoring system in the diagnosis of breast tumor / 中华超声影像学杂志

Objective To explore the application of contrast-enhanced scoring system in the diagnosis of breast tumor.Methods 249 patients with 260 lesions were examined by elastography and contrastenhanced ultrasound before surgery.All the lesions were scored according to the two different methods.Pathological results were made the golden criteria.The diagnosis accuracy of the two methods were compared.Results There were 145 benign and 115 malignant tumors.The diagnosis accuracy,specificity and sensibility of elastography were 85.0％,88.3％,80.1 ％ respectively.The critical value of contrastenhanced ultrasound was between 3 and 4.The diagnosis accuracy,specificity and sensibility of contrastenhanced ultrasound were 88.9％,87.6％,90.4％ respectively.Area under ROC curve of the two methods were 0.901 and 0.910,the difference was not statistically significant.Conclusions Contrast-enhanced ultrasound 5-point scoring system was an initial quantitative criterion for breast tumor diagnosis.The diagnosis accuracy was parallel to that of elastography.

Immunofecal occult blood test predicts the prognosis of patients with chronic kidney disease / 中华肾脏病杂志

Objective To evaluate the value of immunofecal occult blood test (IFOBT) as a prognostic indicator in CKD patients with colorectal impairment.Methods A total of 176CKD patients and 180 healthy adults as control were enrolled.Serum biochemistry was measured at baseline and gastrointestinal bleeding was determined by IFOBT.All the CKD patients were followed up for 4.5 years.Renal replacement therapy or death was defined as end-point event.The Logistic regression analysis was used for risk factors.Kaplan-Meier analysis and COX regression model were used for survival analysis.Results The positive rate of IFOBT in CKD patients was significantly higher than healthy control (17％ vs 5.3％,χ2=13.236,P＜0.01).When comparing with IFOBT negitive patients,IFOBT positive patients were older [(62.030±15.544) years old vs (48.660±19.018)years old,P＜0.01],had higher ESR [(71.800±31.657) mu/h vs (57.210±32.712) mm/h,P＜0.05],C-reactive protein [6.230 (3.000～14.148) mg/L vs 3.000 (3.000～6.833)mg/L,P＜0.05],serum creatinine [419.100 (103.200～546.625) μmol/L vs 175.100 (68.150～462.950) μmol/L,P＜0.05],and had lower hemoglobin level [(97.970±20.590) g/L vs (107.170±27.988) g/L,P＜0.05] and eGFR [11.400 (8.671～53.544) ml·min1·(1.73 m2)1 vs 35.274(10.961～82.145) ml·min-1·(1.73 m2)-1,P＜0.01].There was a negative correlation between IFOBT value and eGFR in CKD patients (r=-0.20,P＜0.01).Positive correlations of IFOBT value with age (r=0.175,P＜0.05) and serum creatinine (r=0.171,P＜0.05) were found.Logistic regression and COX regression analysis showed that IFOBT value,eGFR and ESR were important factors that influenced the prognosis of CKD patients.Kaplan-Meier analysis revealed that IFOBT value ＞100μg/L predicted progression of renal function.Conclusions The prevalence of gastrointestinal bleeding disorder is high in patients with CKD.Value of IFOBT independently predicts decline in renal function of CKD patients.

Research on the Effect of Bone Marrow Stroma Cell on Spine Cord Regeneration / 天津医药

Objective:To investigate the enhancing effect of bone marrow stroma cell(BMSC)on the functional recovery of injured spinal cord by observing the formation of gliotic scar,cavity volume and the cascade of apoptosis of neural cells.Methods:Eighty spinal cord injury(SCI)rat models were made and randomly divided into two groups:group A(n=40),the control group without any treatment;group B(n=40),the injured animals treated with BMSC implantation.The behavioral evaluation was performed using Basso,Beattie and Bresnahan(BBB)scoring system.Scores were recorded at time points of 1,2,4,6 and 8 weeks after transplantation.After 8 weeks,rats were sacrificed.The immunoreactivity of Nogo-A,glial fibrillary acidic protein(GFAP)and the cavity area were measured.The cell apoptosis was detected by TUNEL methods at 1,2,3,7 and 14 days after injury.Results:Compared with control group,treated animals gained higher scores after 8 weeks of transplantation.The number and the size of reactive astrocytes,the average volume of cavity,TUNEL positive cells,the expression of Nogo-A and GFAP reduced significantly in group B compared with those of group A(P＜ 0.05).Conclusion:BMSC possess effects on repairing injured spinal cord and promoting functional recovery through various mechanisms.

Prospective study of improved elasticity scores in the differential diagnosis of malignant and benign breast lesions / 中华超声影像学杂志

Objective To explore the value of improved elasticity scores in differentiating malignant and benign breast lesions. Methods A prospective study was done in 394 patients with 508 breast lesions confirmed by pathology and the elastographic images of the lesions were evaluated by using old and improved elasticity scores respectively. Results The elastographic images of the lesions could be evaluated and classified in all patients by improved elasticity scores but could not be evaluated and classified in 82 lesions by old elasticity scores. The accuracy of ultrasonic elastography for diagnosing benign and malignant breast lesions was 88.8% and 78.1%, respectively by old elasticity scores and improved elasticity scores. Conclusions The elastographic images of breast lesions were accurately evaluated by using improved elasticity scores, and the use of improved elasticity scores is helpful to reduce the biopsy which is not necessary.

Diagnostic value of strain ratio for differentiation breast benign and malignant solid lesions with ultrasonic elastography / 中华超声影像学杂志

Objective To investigate the diagnostic value of strain ratio for differentiation breast benign and malignant solid lesions. Methods Two hundred and sixty-nine patients with 377 lesions (278 benign, 99 malignant) were included in the study. Ultrasonography found the lesions, then ultrasonic elastography got the strain images. By the strain ratio measure method equipped with the ultrasonic machine, strain ratio of the lesion was calculated. Compared with the pathologic diagnosis, the cut-off point of strain ratio was determined with receiver operating characteristic curve. Results There was significant difference between the strain ratio of benign and malignant lesions( P <0. 05). The cut off point of strain ratio was determined as 3. 08, Youden's index was 0. 88,sensitivity was 97. 38% ,and specificity was 91. 33%. Conclusions Strain ratio could be used to differentiate benign and malignant lesions in breast and would be a new diagnostic standard in future.

Color Doppler ultrasound in the diagnosis of lower extremity arterial disease in patients with type 2 diabetes mellitus / 中国介入影像与治疗学

Objective To analyze the value of color Doppler ultrasound in the diagnosis of lower extremity arterial disease in patients with type 2 diabetes mellitus.Methods A total of 800 patients with type 2 diabetes mellitus underwent color Doppler ultrasonography to examine anterior tibial artery (ATA),dorsalis pedis artery (DPA) and posterior tibial artery (PTA).Ultrasonic findings including vascular diameter,stenosis ratio and hemodynamics of lower extremity arterial disease were analyzed retrospectively.Results ATA and DPA had more plaques and stenosis than PTA.There was no statistical difference of vascular diameter,stenosis ratio and hemodynamics between left and right lower extremity artery in patients with type 2 diabetes mellitus including diabetic foot.Conclusion Color Doppler ultrasound is a useful method in the diagnosis of lower extremity arterial disease in patients with type 2 diabetes mellitus,providing information of stenosis ratio and hemodynamics of lower extremity artery,so as contributing to the clinical therapy of this disease.

Application of the binary Logistic regression mode to analyze ultrasonographic features of the solid breast tumors / 中华超声影像学杂志

Objective To evaluate the application of the binary Logistic regression model to analyze ultrasonographie indexes of the solid breast tumors. Methods The indexes of two dimensional gray scale ultrasonography,two dimensional color Doppler flow imaging,three dimensional gray scale ultrasonography, three dimensional color Doppler flow imaging and ultrasonic elastography were evaluated in 151 breast lesions confirmed by surgical pathology. A Logistic regression model for predicting breast rnalignaney on the basis of ultrasonographic indexes was obtained. A receiver operating characteristic (ROC) curve was used to assess the performance of the Logistic regression model. Results Six ultrasonic indexes were finally entering the Logistic regression model. They were elasticity score, shape,internal echo, RI, enhancement of posterior acoustic alteration and the converging pattern in the coronal plane. The area under the ROC curve was 0. 996. The percentage correct of prediction was 97.35 %. Conclusions The multivariate analysis model of binary Logistic regression can describe and analyze the process of differential diagnosis of malignant and benign solid breast tumors by ultrasonography and can select out the valuable indexes of differential diagnosis.

The effect of immunofecal occult blood teat on colorectal cancer screening / 中华内科杂志

Objective To discuss the clinical value of immunofecal occult blood test in screening of colorectal cancer and its precancerous lesions in a large series of health checkup population. Methods Colorectal cancer and its precancerous lesions in 5919 subjects undergoing health checkup in our hospital were screened out by using immunofecal occult blood test from July 2006 to June 2007; positive cases with the test were subjected to colorectal endoscopy or X-ray barium enema examination. Relevant results were analyzed in combination with clinical and pathological data. Results Positive result was obtained in 314 out of the 5919 subjects undergoing health checkup with immunofecal occult blood test; the positive rate was 5.30%. 241 cases(76.75% )of them accepted colorectal endoscopic examination and 23 cases(7.32%) accepted X-ray barium enema examination. The total follow up rate was 84.08% with 50 cases out of contact. After excluding the cases out of cantact, 16 cases of colorectal cancer were found morbidity 2.37‰ including 8(50.00% )cases of Dukes A,7 cases (43.75%)of Dukes B and 1 case of Dukes C (6 .25%).The detection rate of colorectal cancer with postive imunofecal occult blood test was 6.06% (16/264). 94 cases (16.01‰) of adenomatous polyps were found including 55 cases (58.51%) of tubular adenoma, 23 cases (24.47% )of villiform- tubular adenoma and 16 cases(17.02%) of villfform adenoma. Among these cases 55 (58.51%)were solitary and 39(41.49%) multiple. In addition, 6 cases of ulcerative colitis in active phase were found. Altogether 116 (43.94%)of the 264 cases with positive immunofecal blood test and not out of contact were found to have colorectal cancer or its precancerous lesions. Conclusion Immunofecal occult blood test is suitable for screening of colorectal cancer and its precancerous lesions in large series of population. Colorectal cancer and its precancerous lesions may be found in relatively early phase and be eradicated in curable stage, thus to reduce the morbidity and mortality.

A Survey on the Prevalence Rate of Hospital Infection and its Influential Factors / 中国慢性病预防与控制

Objective To understand the basic circumstance of the hospital infection,and to improve the knowledge of medical staff on the management of hospital infection.Methods With bedside observation and examination combined with checking clinical case history,462 inpatients were investigated on current rate of hospital infection and its related factors.Results There were 30 inpatients suffering from hospital infection,the current rate of the hospital infection was 6.49 %;among them,the rate of the lower respiratory tract accounted for 33.00%.The current rates of hospital infection in inpatients with antibiotics(16.56%),or with treatment of urinary catheters(18.52%),or with operation(16.30%),with more than one month hospitalization(19.05%) were significantly higher than those of inpatients without antibiotics(1.00%),without treatment of urinary catheters(5.75%),without operation(4.05%) or with less than one month hospitalization(4.55%)(all P

Consistency between histopathological results of routine endoscopy and biopsy in observing gastric mucosa of patients with non-malignant gastroduodenal diseases / 第二军医大学学报

Objective:To analyze the consistency between the histopathological results of routine endoscopy and biopsy in observing the gastric mucosa of patients with non-malignant gastroduodenal diseases,and to evaluate the necessity of biopsy following gastric endoscopy.Methods: From Jan.2005 to Dec.2005,320 patients who received upper gastrointestinal endoscopy and biopsy because of upper abdominal symptoms were included in this study.The patients were selected consecutively according to their disorders diagnosed by macroscopic endoscopy and were divided into 64 groups.The 5 patients in each group had reflux esophagitis,non-atrophic gastritis,atrophic gastritis,gastric ulcer and duodenal ulcer,respectively.Patients in the same group were matched with each other in gender,age and their history of diseases.The results of endoscopy,including the exudation,congestion,erosion,roughness,bile reflux,etc.,were read by 2 experienced endoscopists.The biopsy was performed by an experienced pathologist and pathological variables included active inflammation,chronic inflammation,atrophy,intestinal metaplasia and atypical hyperplasia.The status of Helicobacter pylori(H.pylori) infection was evaluated by rapid urea test,silver staining and histological methods;the result was deemed positive when the results of either 2 tests were positive.Results: Erosion,exudation,roughness,and H.pylori infection were related with active inflammation;erosion and H.pylori infection were related with chronic inflammation;roughness of mucosa was related with atrophy;roughness and H.pylori infection were related with intestinal metaplasia;and obsolete hemorrhage,H.pylori infection,roughness mucosa,and bile reflux were related with atypical hyperplasia.Macroscopic diagnosis rate of atrophic gastritis was 71.9%(46/64) with a false positive rate of 28.2%(18/64) and a false negative rate of 34.38%(22/64).Conclusion: Macroscopic diagnosis is indicative to pathological changes of gastric mucosa,but the predictive value is relatively poor,making biopsy and pathological examination necessary in the diagnosis of gastric mucosa disorders during routine endoscopic examination.