Effect of neuroelectrophysiological changes on the clinical manifestations and surgical outcomes of lumbar degenerative diseases / 中国骨伤

OBJECTIVE@#To evaluate the effects of electromyography on the clinical manifestations and prognosis after posterior lumbar interbody fusion(PLIF) of degenerative lumbar diseases.@*METHODS@#A retrospective analysis was performed on 68 patients with degenerative lumbar diseases, including 29 males and 39 females, aged 21 to 84 years old, who underwent electromyogram (EMG) from January 2018 to October 2019. The patients were divided into negative and positive groups according to whether theresults of EMG was normal or abnormal, PLIF surgery was performed in both groups. The preoperative duration of illness, postoperative recovery time, operative time, intraoperative blood loss, postoperative ambulation time and length of postoperative hospital stay were recorded. The clinical efficacy was evaluated by visual analogue scale(VAS) of low back and lower limb, the Japanese Orthopedic Association(JOA) score before and after operation.@*RESULTS@#All patients were follow-up from 26 to 39 months. The subjective symptoms, clinical signs, daily activities and JOA total scores after operation in two groups were significantly higher than those before preoperation(P<0.05);the clinical signs score and total JOA score in the negative group at 3 months after operation were higher than those in the positive group(P<0.05). The VAS score of leg pain in the negative group after 1 and 3 months was less than that in the positive group(P<0.05). Patients 's illness time, postoperative recovery time, hospitalization time and implantation time in the negative group were shorter than those in the positive group(P<0.05). At other time points, there was no significant difference in low pain VAS, leg pain VAS, JOA scores in the two groups(P>0.05). There was no significant difference in the operation time and intraoperative bleeding volume between the two groups(P>0.05).@*CONCLUSION@#Patients with normal electromyography had shorter disease duration than ones with abnormal electromyography in lumbar degenerative disease;after PLIF, patients with normal electromyography recovered faster than ones with abnormal electromyography, but the results of electromyography had no effect on the final prognosis of PLIF surgery.

ARDS severity identification based on noninvasive parameter SpO2/FiO2 / 医疗卫生装备

Objective To explore the relationship between SpO2/FiO2(S/F) and PaO2/FiO2(P/F) so as to determine the possibility of ARDS severity identification based on noninvasive parameters. Methods The physiological parameters of corresponding patients were acquired from Medical Information Mart for Intensive Care (MIMIC-Ⅲ),and then divided into a training set and a test set randomly.In the training set the linear relationship between lg(S/F)and lg(P/F)was established with generalized linear regression model,and a log linear regression model was formed with the optimal regression equation;the linear relationship between lg(S/F)and lg(P/F)was compared with that between S/F and P/F.In the test set,the two models were compared on the identification of ARDS in case P/F values were 100(mild ARDS),200(moderate ARDS)and 300(severe ARDS)respectively.Results In the training set(n=61 634)the linear relationship between lg(S/F)and lg(P/F)was deduced as lg(S/F)=1.277+0.437×lg(P/F) (r=0.66,P<0.000 1),and the S/F thresholds in case P/F values were 100,200 and 300 respectively were 131,201 and 271.In the test set (n=26 758)the identification effect was verified with the acquired S/F thresholds,which proved better than that of traditional regression model.Conclusion Noninvasive parameter SpO2/FiO2can replace PaO2/FiO2for the auxiliary diagnosis of ARDS in case the result of blood gas analysis is absent.

Management of medical equipment in hospital ship / 医疗卫生装备

Objective To explore the medical equipment management to facilitate the medical support in the hospital ship.Methods The influences and the ship-mounted equipment on medical equipment were analyzed,the requirements of sea conditions for medical equipment management were explored,the hidden risks and present situation of medical equipment were introduced,and some countermeasures were put forward accordingly.Results The problems of equipment management were analyzed in hospital ship,and some countermeasures were brought out including bringing into better balance the relations between various sectors,enhancing personnel,introducing professional talents,trying for the support from the director and etc.Conclusion The safety of hospital medical equipment is of great significance to the hospital ship itself and the patient.Only to strengthen medical equipment management while focusing on the qualified personnel contributes tobetter fulfilling its mission.

Diagnostic efficiency and result of prostate biopsy for patients with t-PSA between 4.0 and 10 ng/ml / 军事医学

Objective To investigate the diagnostic efficiency and result of prostate biopsy for patients with t -PSA between 4.0 and 10 ng/ml.Methods This analysis was based on 20 qualified research papers from such lectronic databases as PubMed, MEDLINE, EMBASE and Cochrane from January 2010 until September 2017.Data extracted was analyzed using classic Meta-analysis with R software .The random or fixed effect model analysis was used to estimate the rate.Heterogeneity was analyzed using I 2 statistic.Results Totally 5481 patients were included in the 20 research papers. The positive rate of prostate biopsy was 20.6％, with t-PSA between 4.0 and 10 ng/ml, which was higher than the rate in the data from CUA Guide(2014).The difference was statistically significant .Conclusion Patients should be subjected to prostate biopsy if their t-PSA ranges 4.0 from 10 ng/ml regardless of the rate of f/t-PSA.The Gleason grade is relatively low when PSA is in the gray area , and the risk is also low.

Significance of acoustic rhinometry and rhinomanometry in the evaluation of submucous correction of nasal septum and submucous resection of inferior turbinate / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To discuss the significance of acoustic rhinometry and rhinomanometry (RM) in the evaluation of submucous correction of nasal septum and submucous resection of inferior turbinate, and the correlations between the subject symptoms and the object results by acoustic rhinometry and RM in patients before and after operation.</p><p><b>METHODS</b>A prospective study was conducted in forty-eight patients with nasal septal deviation and/or inferior turbinate hypertrophy. The patients were treated by submucous correction of nasal septum and/or submucous resection of inferior turbinate according to the patients' conditions. Visual analogue scale (VAS) was used to estimate the degree of nasal obstruction. Acoustic rhinometry and RM were used to obtain the data of nasal inspiratory effective resistance (IER), nasal expiratory effective resistance (EER), 0 - 5 cm nasal cavity volume (0 - 5 cm NCV), nasal minimal cross-sectional area (NMCA) and distance of the minimal cross-sectional area to the nostril (DCAN). The data were used to assess the airflow function of nasal cavity. Each patient was tested at the time both before and 4 weeks after surgery. The pre-and post operative data were used to calculate paired t-test by SPSS 17.0 and to disclose the Spearman rank correlation between VAS and IER, EER, 0 - 5 cm NCV, NMCA and DCAN individually.</p><p><b>RESULTS</b>The preoperative data showed that VAS was (3.44 ± 1.22), nasal IER was (0.66 ± 0.27) kPa×s×L(-1), nasal EER was (0.68 ± 0.29) kPa×s×L(-1), 0 - 5 cm NCV was (3.98 ± 1.30) cm(3), NMCA was (0.37 ± 0.23) cm(2) and DCAN was (2.42 ± 0.34) cm; and the postoperative data showed that VAS was (1.20 ± 0.80), nasal IER was (0.44 ± 0.21) kPa×s×L(-1), nasal EER was (0.46 ± 0.23) kPa×s×L(-1), 0 - 5 cm NCV was (4.85 ± 1.40) cm(3), NMCA was (0.53 ± 0.44) cm(2) and DCAN was (2.25 ± 0.49) cm. Significant differences existed in VAS, nasal IER, EER, 0 - 5 cm NCV, NMCA and DCAN between pre-and post operative data (t value were 9.163, 4.995, 4.508, -4.204, -2.203, 2.924, all P < 0.05). The correlation coefficient between VAS and IER, EER and 0 - 5 cm NMCA was 0.386, 0.343 and -0.307, respectively (all P < 0.05).</p><p><b>CONCLUSION</b>Both acoustic rhinometry and RM are appropriate methods to be used in the evaluation of submucous correction of nasal septum and submucous resection of inferior turbinate, however, the correlations between the subject symptoms and the object results by acoustic rhinometry and RM need further research.</p>

Pharmacokinetic profiles of methylprednisolone concentration in perilymph and plasma of guinea pig following local administration / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To determine pharmacokinetics profiles of methylprednisolone (MTH) in perilymph and plasma of guinea pig after intratympanic injection of MTH in different concentrations.</p><p><b>METHODS</b>By auripuncture, three different concentrations of MTH were used in guinea pigs: 32.0 mg/ml, 40.0mg/ml and 62.5 mg/ml. Samples of plasma and perilymph of the scala tympani were collected at 1-12 h after administration and the concentrations of MTH were assayed using high-performance liquid chromatography. Auditory brainstem response (ABR) was detected before and 12h after MTH administration.</p><p><b>RESULTS</b>The concentrations of MTH in perilymph were dose-related. The differences of MTH concentrations in perilymph before and at series sampling time after administration were significant in statistics (P < 0.05), except for the intervals of 5 h, 6 h and 12 h. In addition, the concentration of MTH in perilymph was the highest in 62.5 mg/ml group. No MTH was detected in plasma after local administration, except for 1.5 h and 2 h after administration with 62.5 mg/ml. There were not differences in the thresholds of wave III of ABR before and 12h after local MTH administration among three groups (P > 0.05).</p><p><b>CONCLUSIONS</b>The experimental results indicates that the concentration of 62.5 mg/ml of MTH is optimal for treatment inner ear diseases by intratympanic administration among three groups, it get a high concentration in perilymph and not effect on the function of inner ear.</p>