Biomechanical Analysis on NiTi Memory Alloy Stent for Lumbar Interbody Fusion / 医用生物力学

Objective To evaluate biomechanical properties of the nickel-titanium (NiTi) memory alloy stent and its in vitro biomechanical properties for lumbar interbody fusion. Methods The mechanical properties of the NiTi memory alloy stent were tested on mechanical testing machine. Moreover, lumbar interbody fusion was simulated on fresh lumbar specimens, and biomechanical properties of the NiTi memory alloy stent with matching bone graft for used for lumbar interbody fusion were analyzed and compared with the traditional box-shape cage. Results The maximum compressive strength of the NiTi memory alloy stent was ( 12 964 ± 962) N. The maximum deformation within the effective range of memory characteristics was (4. 68±0. 03) mm. The recovery rate of the NiTi memory alloy stent was up to 99. 86% . Compared with the intact lumbar model, the stability of the operative segment after the simulated lumbar interbody fusion using NiTi memory alloy stent alone was increased in the direction of anterior flexion, posterior extension, lateral flexion and rotation, which was equivalent to the box shape cage group (P>0. 05). After the combined use of autogenous bone granule and absorbable bone cement the ROM of the operative segment was further reduced (P0. 05). The pull-out strength of the NiTi memory alloy stent with matching bone graft group was significantly stronger than that of the box-shape cage group (P<0. 05). Conclusions The NiTi memory alloy stent in this study was designed with a matched bone granule-absorbable bone cement graft,which provided a new idea for the further optimization and development of lumbar interbody fusion. With excellent support and deformation properties, this NiTi memory alloy stent is biomechanical equivalent to the traditional box shape cage for lumbar interbody fusion, and can greatly improve the stability of surgical segment and the pull-out strength of implants after the combined use of autogenous bone granule and absorbable bone cement.

A case report of extrarenal Wilms′ tumor / 中华泌尿外科杂志

Extrarenal Wilms′ tumor is extremely rare and has no characteristic clinical manifestations. Diagnosis is difficult before surgery, and is often confirmed by histopathology. Comprehensive treatment by surgery, chemotherapy and radiotherapy is currently adopted for such patients, and the overall survival rate can reach about 90%. Here we report a 2-year-old child with Wilms′ tumor in the left scrotum.

Effects of early intervention on physical and neurological development of 152 premature infants / 中国医师进修杂志

Objective:To study the effects of early intervention on physical and neurological development of premature infants.Methods:One hundred and fifty-two premature infants born in Pan′an County Maternal and Child Health Family Planning Service Center from January 2017 to June 2018 were randomly selected. According to parents′ wishes, 75 cases received regular systematic health care and parenting guidance(control group), and 77 cases received targeted intervention guidance and individualized training on the basis of the control group(intervention group). The results of mental development index (MDI) and psychomotor Development index(PDI) were evaluated at 6 and 12 months respectively.Results:Six and 12 months after treatment, the MDI scores of the intervention group were significant higher than those of the control group [(94.2 ± 5.2) scores vs. (85.3 ± 6.1) scores, (104.9 ± 3.9) scores vs. (91.7 ± 5.7) scores], the PDI scores of the intervention group were also significant higher than those of control group [93.7 ± 4.3) scores vs. (81.7 ± 5.5) scores, (96.9 ± 3.8) scores vs. (83.9 ± 4.6) scores], and there were statistical differences ( P<0.05). Results:Early comprehensive intervention for premature infants has a good effect on their intelligence and motor ability development, which is worthy of clinical application.

Effects of emergency medical service on prognosis of ischemic stroke patients treated with intravenous thrombolysis / 浙江大学学报·医学版

OBJECTIVE@#To investigate the effect of emergency medical service (EMS) on the prognosis of ischemic stroke patients treated with intravenous thrombolysis.@*METHODS@#Clinical data of 2123 ischemic stroke patients treated with intravenous thrombolysis in 70 hospitals in Zhejiang province were retrospectively analyzed. There were 808 patients sent to the hospital by ambulance (EMS group) and 1315 patients by other transportations (non-EMS group). Good outcome was defined as modified Rankin Scale (mRS) ≤ 2 at 3-month. The onset to needle time (ONT), onset to door time (ODT), door to needle time (DNT) and outcome were compared between EMS group and non-EMS group. Binary logistic regression was used to explore the influencing factors for the outcome at 3-month.@*RESULTS@#Compared with the non-EMS group, patients in the EMS group were older, with higher baseline National Institute of Health Sroke Scale (NIHSS) score, and had a higher proportion of atrial fibrillation (all 0.05). Binary logistic regression showed that EMS was not independently associated with good outcome (=0.856, 95%:0.664-1.103, >0.05).@*CONCLUSIONS@#EMS had not improve the outcome of patients receiving intravenous thrombolysis in Zhejiang province.

Advanced treatment time improves outcomes of patients with ischemic stroke undergoing reperfusion therapy / 浙江大学学报·医学版

OBJECTIVE@#To investigate the effect of treatment time on the outcome of patients with ischemic stroke undergoing reperfusion therapy.@*METHODS@#The clinical data of 3229 ischemic stroke patients who received intravenous thrombolysis with or without arterial thrombolysis from 71 hospitals in Zhejiang province from June 2017 to September 2018 were retrospectively reviewed. The good outcome was defined as modified Rankin Scale (mRS) ≤ 2. Binary logistic regression analysis was used to investigate the association of door to needle time (DNT), or door to reperfusion time (DRT) with the outcomes in patients treated by intravenous thrombolysis or bridging arterial thrombolysis, respectively.@*RESULTS@#Binary logistic regression showed that DNT (=0.994, 95%:0.991-0.997, <0.01) or DRT (=0.989, 95%:0.983-0.995, <0.01) were independently associated with good outcomes, respectively. Every hour decreases in DNT resulted in a 4.7%increased probability of functional independence (mRS 0-2) in patients treated by intravenous thrombolysis; Every hour decreases in DRT was associated with a 11.4%increased probability of functional independence in patients treated by intravenous thrombolysis with arterial thrombolysis.@*CONCLUSIONS@#Good outcomes are associated with lower DNT in ischemic stroke patients treated by intravenous thrombolysis or lower DRT in patients treated by intravenous thrombolysis bridging arterial thrombolysis.

Association of atrial fibrillation with hemorrhagic transformation after intravenous thrombolysis in patients with ischemic stroke / 浙江大学学报·医学版

OBJECTIVE@#To investigate the association of atrial fibrillation (AF) with hemorrhagic transformation (HT) in patients with ischemic stroke treated by intravenous thrombolysis.@*METHODS@#Clinical data of 3272 patients treated by intravenous thrombolysis from 71 hospitals in Zhejiang Province during June 2017 and December 2018 were retrospectively reviewed. Intracranial HT was defined as intracranial hemorrhage suggested by imaging examination 24 hours after intravenous thrombolysis. Patients were dichotomized into HT group (=533) and non-HT group (=2739). The association of AF and HT was analyzed by univariate analysis and binary logistic regression.@*RESULTS@#Compared with the non-HT group, the HT group were older, had longer onset to needle time (ONT), higher baseline National Institute of Health Stroke Scale (NIHSS) score, higher baseline glucose level, and higher AF rate (<0.05 or <0.01). Binary logistic regression analysis revealed that AF was independently associated with HT (=2.527, 95%:2.030-3.146, <0.01).@*CONCLUSIONS@#AF is independently associated with the occurrence of HT in ischemic stroke patients treated with intravenous thrombolysis.

Analysis of intravenous thrombolysis time and prognosis in patients with in-hospital stroke / 浙江大学学报·医学版

OBJECTIVE@#To compare the time delay between in-hospital stroke and out-of-hospital stroke patients, and to explore the influence factors for the prognosis of in-hospital stroke patients treated by intravenous thrombolysis.@*METHODS@#Clinical data of 3050 patients with ischemic stroke who received intravenous thrombolysis in 71 hospitals in Zhejiang province from June 2017 to September 2018 were analyzed. Differences of time delay including door to imaging time (DIT), imaging to needle time (INT) and door to needle time (DNT) between in-hospital stroke (=101) and out-of-hospital stroke (=2949) were observed. The influencing factors for the outcome at 3 month after intravenous thrombolysis in patients with in-hospital stroke were analyzed using binary logistic regression analysis.@*RESULTS@#Patients with in-hospital stroke had longer DIT[53.5 (32.0-79.8) min vs. 20.0 (14.0-28.0) min, <0.01], longer IDT[47.5(27.3-64.0)min vs. 36.0(24.0-53.0)min, <0.01], and longer DNT[99.0 (70.5-140.5) min vs. 55.0 (41.0-74.0) min, <0.01], compared with patients with out-of-hospital stroke; patients in comprehensive stroke center had longer DIT[59.5(44.5-83.3) min vs. 37.5(16.5-63.5) min, <0.01], longer DNT[110.0(77.0-145.0) min vs. 88.0 (53.8-124.3) min, <0.05], but shorter INT[36.5(23.8-60.3)min vs. 53.5 (34.3-64.8) min, <0.05], compared with patients in primary stroke center. Age (=0.934, 95% 0.882-0.989, <0.05) and baseline National Institute of Health Stroke Scale score (=0.912, 95% 0.855-0.973, <0.01) were independent risk factors for prognosis of in-hospital stroke patients.@*CONCLUSIONS@#In-hospital stroke had longer DIT and DNT than out-of-hospital stroke, which suggests that a more smooth thrombolysis process of in-hospital stroke should be established.

Effect of different working time on the prognosis of ischemic stroke patients undergoing intravenous thrombolysis / 浙江大学学报·医学版

OBJECTIVE@#To investigate the effect of working time on the prognosis of patients with ischemic stroke undergoing intravenous thrombolysis.@*METHODS@#Clinical data of 3050 patients with ischemic stroke received intravenous thrombolysis from 71 hospitals in Zhejiang Province during June 2017 and September 2018 were retrospective analyzed. Whole day of Saturday and Sunday were defined as weekend; whole day of Monday to Friday were defined as weekdays; Monday to Friday 8:00-17:00 were defined as daytime of weekdays; Monday to Friday 17:01-07:59 on next day were defined as nights of weekdays; unconventional working time were defined as weekend and nights of weekdays. Good outcome was defined as mRS 0-2 at 3 months. Univariate analyses of baseline and prognostic variables in group of weekend and weekdays, nights of weekdays and daytime of weekdays, unconventional working time and daytime of weekdays were performed. Binary logistic regression was used to investigate whether weekend, nights of weekdays and unconventional working time were independent predicting factors of outcome after intravenous thrombolysis, respectively.@*RESULTS@#There was no difference in 7-day mortality, 3-month mortality and good outcome at 3-month between weekend group and weekdays group, nights of weekdays group and daytime of weekdays group, unconventional working time group and daytime of weekdays group (all >0.05). Binary logistic regression results showed that weekends, nights of weekdays and unconventional working time were not independent predicting factors for outcome after intravenous thrombolysis (all >0.05).@*CONCLUSIONS@#The working time has not affected the outcomes of patients with ischemic stroke undergoing intravenous thrombolysis in studied hospitals of Zhejiang province.

Clinical effect of Xingnao acupuncture method and swallowing rehabilitation training in the treatment of dysphagia after stroke / 中国基层医药

Objective To explore the effect of Xingnao acupuncture combined with swallowing rehabilitation training on dysphagia after stroke .Methods 66 patients with dysphagia after stroke were selected as the research subjects ,and they were randomly divided into the observation group and the control group ,33 cases in each group .The control group was given rehabilitation training on the basis of conventional treatment ,while the observation group was given Xingnao acupuncture method on the basis of the control group .The therapeutic effect ,swallowing function and adverse reactions were observed before and after treatment in the two groups .Results After treatment,the treatment effect in the observation group was significantly better than that in the control group ,there was statistically significant difference between the two groups (Z=-4.123,P<0.05).The total effective rates of the two groups were 93.94％, 75.76％,respectively,there was no statistically significant difference between the two groups (χ2 =1.906,P>0.05). After treatment,the Watian drinking water test scores,standardized swallowing assessment (SSA) score,dysphagia score in the control group were (1.39 ±0.47) points,(23.02 ±5.24) points,(1.25 ±0.55) points,respectively, which in the observation group were (0.74 ±0.39) points,(18.26 ±3.71) points,(0.74 ±0.28) points,and the differences were statistically significant compared with before treatment ( the control group:t =21.453,10.644, 26.212,all P<0.05;the observation group:t=27.779,14.15,37.469,all P<0.05),which in the observation group were better than those in the control group ,the differences were statistically significant ( t=6.114,4.259,4.747,all P<0.05).There was no statistically significant difference in the incidence of adverse events between the two groups (P>0.05).Conclusion Xingnao acupuncture combined with swallowing rehabilitation training in the treatment of dysphagia after stroke can effectively improve the swallowing function ,improve the quality of life of patients ,and it is safe,reliable and worthy of promotion in clinical practice .

Cognitive Function in Chronic Schizophrenic Patients with Tardive Dyskinesia / 中国临床心理学杂志

Objective: To explore the cognitive function of chronic schizophrenic patients with tardive dyskinesia(TD).Methods: 82 chronic schizophrenic patients with TD,70 chronic schizophrenic patients without TD were accepted 3 neuropsychological tests including WMS,WCST and TMT.Results: Compared with non-TD group in WCST,TD group had poorer performance in the number of error responses,the selective error rate,error thinking time,the number of perservation of responses and the rate of conceptualization responses.Additionally,TD group had poorer performance in TMT-PartB.Conclusion: Chronic schizophrenic patients with TD had significantly cognitive impairment,involving the frontal cortex.