1.An anatomical and clinical study of modified anterior approach in management of thoracolumbar injury
Hongbing CHENG ; Kesu HU ; Chengzhong PAN
Chinese Journal of Orthopaedics 1996;0(10):-
Objective To observe the morphology of thoracolumbar spinal nerve roots and their surrounding structures, in order to find out their anatomical relationship and to improve surgical procedures as well as to reduce the operative injury and complications. Methods 16 adult cadavers were studied anatomically. The diameters of spinal nerve roots from T10 to L3 at the outlet of intervertebral foramen, the percentages of the distance from spinal nerve roots to the upper border of corresponding vertebral bodies in vertebral height, the angles between spinal nerve roots with lateral border of vertebrae were measured and analyzed. The surgical incision and procedure for the treatment of thoracolumbar fracture were designed and applied in 58 patients of thoracolumbar injury. Results The diameters of spinal nerve roots increased gradually from T10 to L3 in the intervertebral foramen. The percentages of the distance from spinal nerve roots to the upper border of vertebrae in vertebral height gradually became larger too. The angles between spinal nerve roots with vertebral bodies diminished gradually. Around intervertebral foramen, the pattern of spinal nerves and blood vessels was arranged in order as vein, nerve and artery from above down below. The nerves and vessels extended out of the intervertebral foramen together. In clinical practice, 58 cases of thoracolumbar injury were surgically treated with traditional anterior approach and "renal" incision in 35 cases, and with modified anterior approach in "┑" shape in 23 cases. Prior to the modification of surgical techniques, the mean amount of blood loss was 670 ml, the mean operation time was 199 min; however, by the modification of surgical procedures, the mean amount of blood loss decreased to 435 ml, and the mean operation time reduced to 137 min. In an average follow-up of 9 months, the spine recovered to normal curvature and alignment in all cases; the fusion rate was 100%; no failure of implant occurred; neurological function was improved at least one grade in 94.5%. Conclusion Modified anterior approach is helpful to reduce operative injuries and complications. It makes surgical manipulation feasible comparing to the traditional approach.
2.Observations on the Efficacy of Acupuncture plus Bloodletting Therapy for Post-stroke Sensory Disturbance
Dan PAN ; Boxu LANG ; Chengzhong JIN ; Lingqing JIN
Shanghai Journal of Acupuncture and Moxibustion 2016;35(7):782-785
Objective To investigate the clinical efficacy of acupuncture plus bloodletting therapy for post-stroke limb sensory disturbance.Methods Ninety patients with post-stroke limb sensory disturbance were randomly allocated to treatment and control groups, 45 cases each. The treatment group received acupuncture plus bloodletting therapy and the control group, acupuncture alone. The disease and motor function were scored in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results There were statistically significant pre-/post-treatment differences in the disease score and the motor function score in the two groups (P<0.05). There were statistically significant post-treatment differences in the disease score and the motor function score between the treatment and control groups (P<0.05). The total efficacy rate was 91.1% in the treatment group and 66.7% in the control group; there was a statistically significant difference between the two groups (P<0.01). Conclusions Acupuncture plus bloodletting therapy is an effective way to treat post-stroke sensory disturbance. It can improve the clinical symptoms and motor function in the patients.
3. Guidance on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period (First Edition)
Guocheng ZHANG ; Xiaoning CHENG ; Hui DING ; Zhaoling SHI ; Ruying LI ; Zhou FU ; Qiang CHEN ; Dongchi ZHAO ; Runming JIN ; Guoming NIE ; Jirong LU ; Changshan LIU ; Deyu ZHAO ; Jiahua PAN ; Zhichun FENG ; Yuan SHI ; Zhengkun XIA ; Chengzhong ZHENG ; Jinjin JIANG ; Junxia WANG ; Yuejie ZHENG ; Yunxiao SHANG ; Wei XIANG ; Baoping XU ; Kunling SHEN ; Tianyou WANG ; Yonghong YANG ; Quan LU
Chinese Journal of Applied Clinical Pediatrics 2020;35(2):97-104
Novel Coronavirus Pneumonia (NCP) is a class B infectious disease, which is prevented and controlled according to class A infectious diseases. Recently, children′s NCP cases have gradually increased, and children′s fever outpatient department has become the first strategic pass to stop the epidemic. Strengthening the management of the fever diagnosis process is very important for early detection of suspected children, early isolation, early treatment and prevention of cross-infection. This article proposes prevention and control strategies for fever diagnosis, optimizes processes, prevents cross-infection, health protection and disinfection of medical staff, based on the relevant diagnosis, treatment, prevention and control programs of the National Health and Health Commission and on the diagnosis and treatment experience of experts in various provinces and cities. The present guidance summarizes current strategies on pre-diagnosis; triage, diagnosis, treatment, and prevention of 2019-nCoV infection in common fever, suspected and confirmed children, which provide practical suggestions on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period.