Percutaneous kyphoplasty in the treatment of Kümmell disease in lumbar scoliosis: A case report.

BACKGROUND: Due to mechanical imbalance in the spine, elderly scoliosis patients tend to develop vertebral fracture nonunion, i.e., Kümmell disease, when osteoporotic vertebral compression fractures occur. However, accompanying vertebral rotational deformities make surgical procedures challenging risky. Such patients are usually compelled to undergo conservative treatment and there are very few reports on minimally invasive surgeries for them. We first-time report a patient with Kümmell disease and lumbar scoliosis treated with percutaneous kyphoplasty (PKP) under O-arm guidance. CASE SUMMARY: An 89-year-old female was admitted to the hospital due to delayed low back pain after a fall. She was diagnosed with Kümmell disease based on physical and radiologic examinations. The patient experienced severe scoliosis and subsequently underwent O-arm-guided kyphoplasty, resulting in a significant alleviation of low back pain. CONCLUSION: PKP has good efficacy in treating Kümmell disease. However, surgical risks are elevated in scoliosis patients with Kümmell disease due to the abnormal anatomical structure of the spine. O-arm assisted operations play a crucial role in decreasing surgical risks.

Effects of oral α-lipoic acid administration on body weight in overweight or obese subjects: a crossover randomized, double-blind, placebo-controlled trial.

OBJECTIVE: Alpha-lipoic acid (ALA) has shown beneficial properties on diabetes and obesity. The aim of this study was to examine the effects of oral ALA on body weight in subjects with overweight or obese. DESIGN: Single-centre, randomized, double-blind, crossover controlled study. PARTICIPANTS: A total of 166 subjects of Chinese Han ethnicity with a BMI ≥25 kg/m2 were screened and 103 subjects fulfilled the study requirements, in terms of informed consent and participation to the study. MEASUREMENTS: The subjects were randomized (1:1) to receive either ALA (1200 mg/day) or placebo treatment in a crossover design for 8 weeks. The primary end-point was the change in body weight. The secondary end-points were the changes in waist circumference, BMI, lipid profile, plasma leptin levels and the adverse events that occurred following ALA treatment. RESULTS: The changes in the body weight and waist circumference noted in the ALA group were significantly different compared to the placebo group as demonstrated by mixed model statistical analysis (both P < 0·05). No real weight reduction was seen in the ALA group, and no significant differences were noted as regards cholesterol levels, triglyceride levels, high-density lipoprotein cholesterol levels and adverse events between the two groups. The administration of ALA was well tolerated, and no serious adverse events were noted. CONCLUSIONS: Oral administration of ALA (1200 mg/day) for 8 weeks induced mild weight loss accompanied by a reduction in waist circumference.

[Bone setting manipulation combined with surgery for the treatment of calcaneal fractures].

OBJECTIVE: To investigate the clinical effects of bone setting manipulation on simplified operation and swelling reduction in treating calcaneal fractures. METHODS: From December 2005 to November 2010, 42 patients with calcaneal were reviewed, including 25 males and 17 females, ranging in age from 18 to 74 years, with an average of 41.4 years. Twenty patients had fractures in the left and 22 in the right. Twenty-three patients were treated with anatomical plate fixation, 19 patients were treated with Kirchners wires or cannulated screws fixation. The average period of swelling in soft tissue, joint function and complications were evaluated. RESULTS: Forty-two patients were followed up, and the duration ranged from 3 to 18 months, with a mean of 8.3 months. The pain was markedly relieved at the next day after reduction, and the swelling was relieved in 3 to 5 days. The operative was simplified and the average operative time was 90 minutes. The swelling was relieved in 4 to 7 days after the operation, and the necrosis of skin was not found. The average postoperatively Böhler angle was (31 +/- 3.2) degrees. Gissane angle was (112 +/- 5.3) degrees. Calcaneal width was (30.2 +/- 0.89) mm. According to Maryland foot function score system, 16 patients got an excellent result, 18 good, 6 fair and 2 bad. CONCLUSION: The operation is simplified, and skin complications decrease, as well as the detumescence period is shortened.

[The multi-level Meta analysis model combining individual level data with aggregative level data].

OBJECTIVE: To explore the multi-level Meta analysis model combining individual level data with aggregative level data and its application in medicine. METHODS: The difference in respect to "decreased hemoglobin A(1c)" between treatment with roglizatone and treatment without roglizatone was obtained by combining individual level data from clinical trial of roglizatone natrium with aggregative level data from literatures. This endeavor was regarded as an example to construct the multi-level Meta analysis model combining individual level data with aggregative level data. RESULTS: The baseline hemoglobin A(1c) was 9% and the dose of drug was 4 mg per day. The average difference in "decreased hemoglobin A(1c)" between treatment with and without roglizatone was 0. 464%, with a 95% CI from 0.168% to 0.760%. CONCLUSION: In case that individual data are available, the multi-level Meta analysis model combining individual level data with aggregative level data can utilize the data resources adequately and the results obtained should be more accurate.

[A Markov model to access long-term effects of rosiglitazone natrium on the treatment of type 2 diabetes].

OBJECTIVE: The aim of this study was to estimate the long-term treatment effects of Rosiglitazone-natrium in type 2 diabetes. METHODS: A Markov decision model was developed to predict, over 10 years, mortality with or without Rosiglitazone-natrium treatment. RESULTS: During 10 years research, 14.2% patients developed to complications of type 2 diabetes mellitus, 3.8% patients should be dead in Rosiglitazone-natrium treatment group. 22.7% patients developed to complications of type 2 diabetes, 6.6% patients should be dead in non-Rosiglitazone-natrium treatment group. CONCLUSION: Markov decision model should be useful in accessing the long-term effects of drug treatment. Evidence on long-term benefit of Rosiglitazone-natrium could be of importance for future decision making.