Progress of gait analysis in adolescent idiopathic scoliosis / 中华骨科杂志

Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine,which not only affects spinal anatomy,mobility and trunk symmetry,but also leads to the changes of human locomotion through pelvic.During the past 30 years,though great progress has been made in the treatment of AIS,the pathogeny of AIS is still uncertain.Most scholars believe that many factors contribute to the pathogeny of AIS,however,some studies have shown that poor posture during walking and poor manage of balance could lead to the progress of scoliosis.Gait is a behaviour characteristic during walking,and normal gait is the result of nervous system,musculoskeletal system,proprioception and vision.Any disease of the system above may cause abnormal gait.Gait analysis can spot the key links and impact factors of abnormal gait by observing and measuring the testers' walking,reflect the abnormal gait objectively and quantitatively,and provide reference opinions for the recovery and treatment of patients.At present,gait analysis has been mostly applied in hemiplegia,cerebral palsy and knee osteoarthritis.In recent years,gait analysis has been increasingly used in AIS patients.There have been many researches about the kinematics and kinetics of gait analysis in adolsecent idiopathic scoliosis abroad and some positive results have been reported..But in China,it's still in the initial stage.We reviewed the published papers about gait analysis in AIS patients,and summarized the kinematics,kinetics and different means of intervention on gait in AIS patients.We hope it will provide references for our researches.

Radiological characteristics and clinical manifestation of isolated lumbar foraminal stenosis / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss radiological characteristics and clinical manifestation of isolated lumbar foraminal stenosis.</p><p><b>METHODS</b>From March 2011 to March 2014, 21 patients with isolated degenerative lumbar foraminal stenosis accepted lumbar decompression and fusion in Beijing Luhe Hospital. Intervertebral disc space was evaluated by measuring the position of joint-body line on preoperative X-ray. Bilateral foraminal area of the corresponding segment in CT (sagittal view of 2D reconstruction) and MRI (T2W1 sagittal view) were measured by Surgimap software. For patients with unilateral symptoms, foraminal area of the affected side was compared with that of the contralateral side. Foraminal area of the same segment on CT was also compared with that on MRI. Preoperatively and at the final follow-up, visual analogue score (VAS) and Oswestry Disability Index (ODI) were used to evaluate clinical outcomes.</p><p><b>RESULTS</b>All patients had a follow-up over 6 months and the average follow-up was 16.8 months (7-42 months). Of the 21 patients (26 segments), 12 segments showed gross narrowing and 14 segments showed slight narrowing. After preoperative measurement on MRI, 6 patients had foraminal stenosis of grade 2, and 15 patients had foraminal stenosis of grade 3, showing no significant difference in clinical outcomes. Compared with the foraminal area of the unaffected side, the affected side showed a decrease of 16% on CT and 28% on MRI, and the difference was statistically significant (t = 3.453, P < 0.05). The foraminal area measured on CT was larger than that measured on MRI (P < 0.05). Compared with that preoperatively, VAS (back pain), VAS (leg pain) and ODI showed significant improvement at the final follow-up (P < 0.05).</p><p><b>CONCLUSIONS</b>Radiological examinations as X-ray, CT, MRI and intervertebral foramen block technique play an important role in the diagnosis of foraminal stenosis. Soft oppression caused by hyperplasia and hypertrophy of transforaminal ligment or joint capsule may be important promoters of degenerative lumbar foraminal stenosis. Lumbar foraminal decompression and interbody fusion can satisfactorily improve preoperative symptoms.</p>

Correlation analysis of postoperative blood volume changes and delirium in elderly patients undergoing surgery for hip fracture / 中国综合临床

ObjectiveTo explore the relationship of blood volume changes and postoperative delirium in elderly patients undergoing surgery for hip fracture.Methods One hundred and fifty elderly patients who underwent surgery for hip fracture were enrolled in the study.Delirium was diagnosed by Confusion Assessment Method(CAM).Preoperative,intraoperative and postoperative data were collected,and the correlation of postoperative delirium and blood volume changes were analyzed by logistic regression analysis.ResultsA total of 59 patients(28 males and 31 females)had delirium after surgery and the occurrence rate of postoperative delirium was 39.3％ (59/150).The average age in delirium group was significantly older than that in the control group[ (77.71 ±6.63)years old vs(73.79 ±5.42) years old,t =-3.958,P ＜0.001 ].The average hemoglobin concentration and hematocrit in delirium group were both less than that in control group whether before surgery or at 7 days after surgery( before surgery:average hemoglobin concentration:[ ( 117.80 ± 16.59)g/L vs( 123.92 ±14.61 ) g/L,t =2.378,P =0.019; hematocrit:(0.355 ± 0.154) vs(0.372 ± 0.210),t =2.291,P =0.023 ;7days after surgery:average hemoglobin concentration:(98.15 ± 11.51 ) g/L vs ( 102.33 ± 9.88 ) g/L,t =2.369,P =0.019; hematocrit:(0.296 ± 0.040 ) vs (0.306 ± 0.030),t =-3.958,P ＜ 0.001 ].There was no significant difference on gender,fracture type,surgical approach,operative time,blood loss and hemoglobin concentration at 1,3 days after surgery between the two groups( P ＞0.05 ).Logistic regression analysis showed that age ( OR 3.280 ),education ( OR 0.389 ),and hemoglobin concentration at 7 days after operration ( OR 1.097) were significantly related to the occurrence of postoperative delirium ( P ＜ 0.05 ).Conclusion Our findings suggest that the risk for postoperative delirium is the result of more than one factor.Older age,continued postoperative low hemoglobin concentration and low degree of education present high risk of delirium in patients underwent surgery for hip fractures.

Measurement and clinical significance of posterior slope angle of proximal tibial medial meniscus in normal Chinese / 中国矫形外科杂志

[Objective]To measure the posterior sloope angle of proximal tibial medial meniscus(PSAPTMM) in Chinese adult,provide parameters for improving the design of knee prosthesis more suitable for Chinese and for resecting tibial plateau in total knee arthroplasty.[Method]Sixty-three male knees and 52 female knees of Chinese,without tibial deformity,genu varum and valgum,abnormal change of articular surface,and tibial trauma,with average age of 45.6 years(ranged,20~74 years,were divided into 3 groups according to persons age: group A,18~39 years;group B,40~50 years;group C,more than 60 years.The sagital tomography of medial meniscus of MRI were taken,stored,and measured using JENNY way.The data were analyzed statistically.[Result]By two factors analysis,the sex and age had no significant influence on PSAPTMM,and the angle was not different between the left and right knee.In male adult,the average degree of left PSAPTMM was(2.7?1.8,of the right(2.9?1.7)? with an average degree of both sides of(2.9?1.8.In female adult,the average degree of left PSAPTMM was(3.5?1.7,of the right(2.8?1.6,with the average degree of both sides(3.2?1.7.The average degree of group A were(3.6?1.6,group B(2.7?1.8,group C(2.8?1.7.There showed no significant difference of PSAPTMM between sex,side,and age.[Conclusion]The average degree of PSAPTMM in northern Chinese adult is(3.0?1.7,ranges from(0~6.2,and is larger than that of the westerns.

Clinical observation of lumbar muscle strain treated by Biqi Capsule / 中华中医药杂志

Objective:To study curative effect of Biqi Capsule on lumbar muscle strain. Methods:120 patients who meet the full diagnostic criteria were grouped into the treatment group (66 patients) and the control group (54 patients) at random. The treatment group was treated with Biqi Capsule per os,while the control group was treated with western medicine Composite Chlorzozazone tablets per os.The comprehensive curative effects on the two groups were summarized.Results:The total effective rate of the treatment group and the control group were 92.4% and 79.6% respectively;No significant differences in two groups in statistics (P=0.06).The VAS score of the treatment group and the control group were (0.95?1.63) and (1.83?2.39) respectively.The curative effect was found to be better in the treatment group than that in the control group (P

Relation between antidiuretic hormone and nocturnal polyuria in patients with spinal cord injury / 中华创伤杂志

Objective To evaluate the relationship of diurnal variation of antidiuretic hormone (ADH) with urinary output,serum osmolality and blood pressure in spinal cord injury (SCI) patients. MethodsThe study was prospective,random and contrastive. Twenty complete SCI patients (two females and 18 males,Complete SCI group) and ten healthy controls (two females and eight males,control group) were studied. Urinary output and osmolality in the day time (8:00-20:00) and at night (20:00-8:00) were recorded. Blood samples for the measurement of serum osmolality and ADH were drawn at 14:00 and 2:00. Results There was very significant difference in regard of urinary output between day time and night time in complete SCI Group and control Group ( P 0.05). However,ADH level increased in the healthy Group at night,with a very significant difference ( P