Objective To explore the indications, intraoperative problems and management of its complications of the microendoscopic discectomy (MED) in the treatment of lumbar intervertebral disc herni-ation through posterior approach. Methods 242 cases of lumbar disc herniation treated by MED were re-viewed retrospectively from March 2000 to March 2002. Of the 242 cases, there were 171 males and 71 fe-males aged from 19 to 71 years with an average of 34 years. Among them, the lesions were located at single level in 193, double levels in 46, and three levels in three. All of 242 patients were examined with CT, 48 of which were performed MR. Results 205 herniated discs of the single level were removed, 36 of the double levels, and one of the three levels. It was average 2.2 days for the patients to get off bed ranging from 24 hours to 6 days. Postoperative hospitalization was from 3 to 12 days with an average of 5.2 days. Among the intraoperative complications, dural tear happened in four, nerve root injury in two, and mistakes of localiza-tion in one. While in postoperative complications, there was discitis in one which happened at three weeks postoperatively, and was cured with antibiotics and ambulation for five months. All incision healed in one stage, except one suffered from superficial infection and healed by dress changing. All cases were followed up for 2 to 15 months with an average of 6 months. The average period for the patients retuning to daily life was 3.6 weeks, and 52.4% of the patients restored to previous work. According to Macnab's evaluation sys-tem for clinical outcomes, the results showed excellent in 183, good in 44, fair in 13 and poor in two, so the rate of excellent and good was 94%. However, there were two cases converted to open operation because of compressive neurological dysfunction. Conclusion Appropriate control of indications and skillful surgical technique are the key points to decrease the complication, and to improve the curative effect.

Objective To assess the effects of music intervention on physiological and psychological responses of patients with cancer. Methods A computerized search in China Biology Medicine, China National Knowledge Infrastructure,Wanfang data ,VIP, Cochrane library, Web of Science and PubMed was performed for relevant randomized control trials comparing the effects of music intervention on physiological and psychological responses of patients with cancer. The quality of studies was critically appraised and data were extracted by two reviewers independently. The Cochrane-Handbook5.0 was used to evaluate the quality of studies. Data was analyzed by RevMan5.0 software. Results A total of 29 randomized control trials were involved. Eleven studies about the effects of music intervention on anxiety level of patients with cancer were assessed with Self-rating Anxiety Scale,Meta analysis confirmed that music intervention could effectively reduce the anxiety level of patients with cancer (WMD=-11.74, 95%CI-11.94--8.53, P<0.01). Four studies about the effects of music intervention on anxiety level of patients with cancer were assessed with state-trait anxiety inventory,Meta analysis confirmed that music intervention could effectively reduce the anxiety level of patients with cancer (WMD=-8.24, 95%CI-9.44--7.04, P<0.01). Meta-analysis showed that music intervention was able to relieve anxiety, depression, pain of patients with cancer. Two studies about the effects of music intervention on anxiety level of patients with cancer were assessed with Hamilton Anxiety Scale,Meta analysis confirmed that music intervention could effectively reduce the anxiety level of patients with cancer (WMD=-3.37, 95%CI-4.93--1.82, P<0.01). Fourteen studies about the effects of music intervention on depression level of patients with cancer were assessed with Self-rating Depression Scale,Meta analysis confirmed that music intervention could effectively reduce the depression level of patients with cancer (WMD=-8.12, 95%CI-10.75--5.49, P<0.01). Three studies about the effects of music intervention on depression level of patients with cancer were assessed with Hamilton Depression Scale,Meta analysis confirmed that music intervention could effectively reduce the depression level of patients with cancer (WMD=-3.27, 95%CI-6.34--0.21, P=0.04). A total of 9 studies were conducted to evaluate the effects of music intervention on patients with the pain Visual Analogue Scale,Meta analysis confirmed that music intervention could effectively reduce the pain level of patients with cancer (WMD=-0.83, 95%CI-1.23--0.44, P<0.01).A total of 6 studies were conducted to evaluate the effects of music intervention on heart rate in cancer patients,Meta analysis confirmed that music intervention could stabilize the heart rate of patients (WMD=-3.38, 95%CI-5.13--1.62, P=0.002).A total of 6 studies were conducted to evaluate the effects of music intervention on systolic blood pressure in patients with cancer,the results of Meta analysis showed that music intervention could stabilize the systolic pressure in patients (WMD=-5.34, 95%CI-7.95--2.73, P<0.01). Conclusions Music intervention has effects on reducing potentially harmful psychological responses of patients with cancer,which deserve to be explored and spread in clinical practice.

OBJECTIVE: To study the protective effect of astragaloside on nerve of in vitro and in vivo model of Parkinson disease (PD).METHODS: MPP+ induced PC12 cell injury to establish in vitro PD model.PD mice model was induced by MPTP.MTT assay was used to determine the effect of astragaloside on survival rate of PC12 cell induced by MPP+ and the content of LDH and MDA.The effect of astragaloside on spontaneous behavior and the content of striatal DA and HVA were also detected.RESULTS: 25 ?mol?L-1,50 ?mol?L-1,100 ?mol?L-1 dose of astragaloside inhibited the decrease of survival rate of PC12 cell induced by MPP+ in dose dependent manner.10 ?mol?L-1,20 ?mol?L-1,40 ?mol?L-1 dose of astragaloside can obviously enhanced spontaneous behavior of model mice,and reduced the content of striatal DA and HVA.CONCLUSION: Astragaloside can protect nerve of in vivo PD and in vitro PD model.

BACKGROUND:At present,open reduction and internal fixation and minimally invasive needle aspiration are commonly used in patients with Sanders types Ⅱ and Ⅲ calcaneal fractures.However,there is little comparison between the clinical efficacy of the two methods and high-level clinical evidence is still available. OBJECTIVE:To compare the curative effect of Sanders types Ⅱ and Ⅲ calcaneal fractures treated by three-dimensional digital model-assisted minimally invasive needle penetration and tarsal sinus incision and manual reduction and internal fixation with steel plate. METHODS:From January 2021 to October 2022,80 patients with Sanders types Ⅱ and Ⅲ calcaneal fractures who were treated in the Department of Orthopedics,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province were randomly divided into control group(40 cases)and observation group(40 cases).The control group was treated with manual reduction and internal fixation with steel plate through the traditional tarsal sinus incision,while the observation group was treated with a three-dimensional digital model assisted with minimally invasive needle penetration fixation.The operation time,blood loss,hospitalization time and fracture healing time of the two groups were recorded.The changes in Maryland score,AO-FAS score,pain visual analog scale score,quality of life score(SF-36 score),and imaging parameters(B?hler angle,Gissane angle,calcaneal length,width and height)were observed before and 12 months after operation in the two groups.The complications during the follow-up were recorded. RESULTS AND CONCLUSION:(1)Operation time,blood loss,hospitalization time and fracture healing time in the observation group were lower than those in the control group(all P<0.05).(2)The Maryland score,AO-FAS score,SF-36 score,B?hler angle,Gissane angle,calcaneal length and height of the two groups after treatment were significantly higher than those before treatment(all P<0.05).Visual analog scale score and calcaneal width were significantly lower than those before treatment(all P<0.05).(3)After 12 months of follow-up,the incidence of complications in the observation group was lower than that in the control group(all P<0.05).(4)In conclusion,the treatment of Sanders types Ⅱ and Ⅲ calcaneal fractures with three-dimensional digital model-assisted minimally invasive needle penetration fixation can significantly improve the operation time,bleeding volume and other perioperative indicators,and can reduce the occurrence of multiple complications.The recovery of ankle function,relief of pain symptoms,and improvement of quality of life are equivalent to traditional therapy.

ObjectiveTo explore the effects of applying multidisciplinary team based action study method in quality control of blood samples before test in order to improve the quality of inpatients' blood samples before test. MethodsA multidisciplinary team which was mainly led by the Nursing Department, professionally guided by the department of Clinical Laboratory and assisted by the Service Center as well as the Information Center was established. We analyzed the quality of the blood samples before examination in August 2017 in a Class Ⅲ Grade A hospital, and used the action study method of planning, action, observation and reflection as the axis to intervene. After 3 cycles, the number of unqualified blood samples of inpatients from August 2017 to August 2018 were compared. ResultsThe unqualified rate of blood samples had an overall downward trend during the period from August 2017 to August 2018,and there was statistical difference before and after intervention(P＜0.01). ConclusionsMultidisciplinary team collaboration provides guarantee for the improvement of blood samples quality before examination, and the application of action study method regulate the quality of blood samples in each procedure before examination and effectively reduce the unqualified rate of the blood samples.

Objective:To explore the diagnostic performance of cardiac magnetic resonance imaging (CMR) with T1 mapping and T2 mapping for detection of acute phase of ischemic cardiomyopathy.Methods:Twenty-four patients with acute myocardial infarction (AMI) detected by coronary angiography from May 2020 to April 2021 in Tianjin First Center Hospital were selected. All patients underwent CMR (Philips Ingenia 3.0-T) at (9±4) days after definite diagnosis, which was defined as the first diagnosis. After 3 months and 6 months of chronic myocardial infarction (CMI) phase, one CMR was performed. On the same period with age and sex matching, a total of 26 cases of healthy volunteers and outpatient with non-specific chest pain and CMR examination without abnormality as control group. Plain scan included Cine, T2-weighted (STIR), and native T1/T2 mapping. The enhanced scan included perfusion, late gadolinium enhancement, post-T1 mapping. The changes of myocardial quantitative parameters before and after myocardial infarction were compared. Receiver operator characteristic curves (ROC curve) were developed to evaluate, compare, and distinguish the changes in the AMI group and the CMI group after 6 months.Results:Pre-enhanced T1 value, T2 value and extracellular volume (ECV) of AMI group were significantly higher than those of control group [pre-enhanced T1 value (ms): 1 438.7±173.4 vs. 1 269.2±42.3, pre-enhanced T2 value (ms): 49.8±9.3 vs. 21.7±4.0 , ECV (%): 33.2±10.2 vs. 27.2±2.1, all P < 0.05]. ECV was significantly higher in AMI (%: 33.2±10.2 vs. 27.2±2.1), but stabilized after 3 months (%: 33.2±10.2 vs. 32.4±5.1), and after 6 months later (%: 27.7±4.9 vs. 32.4±5.1), there were no significant difference (all P > 0.05). Pre-enhanced T1 and T2 values were significantly higher in AMI, lower after 3 months, but significantly decreased after 6 months [pre-enhanced T1 values (ms): 1 438.7±173.4 vs. 1 272.1±25.2, pre-enhanced T2 values (ms): 49.8±9.3 vs. 29.0±4.0, all P < 0.05]. The ROC curve showed that the specificity of pre-enhanced T1 and T2 values between AMI and CMI were 100%, and the sensitivity were 72.7%, 100%, respectively, pre-enhanced T1 and T2 value could be better distinguish between AMI and CMI diagnosis method. Conclusion:T1 mapping and T2 mapping with ECV can clearly diagnosis ischemic cardiomyopathy, especially pre-enhanced myocardial T1 and T2 values which is non-invasive diagnosis method of AMI, and can distinguish AMI or CMI, has a great significance to the patient's clinical treatment and follow-up.

Objective:To investigate the reoperation and perioperative management of residual cyst wall with perineal intractable sinus after resection of presacral cyst tumors.Methods:The clinical data of 29 patients with residual cyst wall and perineal intractable sinus after resection of presacral cyst tumors in Affiliated Cancer Hospital of Zhengzhou University from January 2014 to August 2019 were reviewed, including the characteristics of the residual cyst wall with perineal intractable sinus after resection of presacral cyst tumors, surgical method, and perioperative management.Results:Twenty-nine patients with residual cyst wall and perineal intractable sinus after resection of presacral cyst tumors, including 9 cases of epidermoid cysts, 7 cases of dermoid cysts, 10 cases of mature teratomas and 3 cases of malignant cysts (including malignant transformation of caudate cyst and teratoma); The 29 patients underwent posterior approaches for cyst resection in other hospital before, of whom 1 patient underwent posterior combined with transabdominal approach. All of thes patients underwent resection of residual presacral cyst wall and perineal intractable sinus in our hospital, of whom 25 patients underwent a transperineal approach through an arc-shaped incision anterior to the apex of the coccyx, and the other 4 patients underwent transperineal arc-shaped incision combined with transabdominal approach. All of the patients were cured without serious complications occurring, postoperative pathological and the magnetic resonance imaging diagnosis showed that the residual cyst wall and perineal intractable sinus were all completely removed.Conclusion:Appropriate surgical approache and perioperative treatment for the patients with residual cyst wall and perineal intractable sinus are very important to promote the resection of residual cyst wall and the healing of perineal intractable sinus.

Objective:To investigate the reoperation and perioperative management of residual cyst wall with perineal intractable sinus after resection of presacral cyst tumors.Methods:The clinical data of 29 patients with residual cyst wall and perineal intractable sinus after resection of presacral cyst tumors in Affiliated Cancer Hospital of Zhengzhou University from January 2014 to August 2019 were reviewed, including the characteristics of the residual cyst wall with perineal intractable sinus after resection of presacral cyst tumors, surgical method, and perioperative management.Results:Twenty-nine patients with residual cyst wall and perineal intractable sinus after resection of presacral cyst tumors, including 9 cases of epidermoid cysts, 7 cases of dermoid cysts, 10 cases of mature teratomas and 3 cases of malignant cysts (including malignant transformation of caudate cyst and teratoma); The 29 patients underwent posterior approaches for cyst resection in other hospital before, of whom 1 patient underwent posterior combined with transabdominal approach. All of thes patients underwent resection of residual presacral cyst wall and perineal intractable sinus in our hospital, of whom 25 patients underwent a transperineal approach through an arc-shaped incision anterior to the apex of the coccyx, and the other 4 patients underwent transperineal arc-shaped incision combined with transabdominal approach. All of the patients were cured without serious complications occurring, postoperative pathological and the magnetic resonance imaging diagnosis showed that the residual cyst wall and perineal intractable sinus were all completely removed.Conclusion:Appropriate surgical approache and perioperative treatment for the patients with residual cyst wall and perineal intractable sinus are very important to promote the resection of residual cyst wall and the healing of perineal intractable sinus.

OBJECTIVE: To investigate the value of T2 mapping in the assessment of myocardial changes and prognosis in patients with acute ST segment elevation myocardial infarction (STEMI). METHODS: A retrospective study was conducted. A total of 30 patients with acute STEMI admitted to Tianjin First Central Hospital from January 2021 to March 2022 were enrolled as the experimental group. At the same time, 30 age- and sex-matched healthy volunteers and outpatients with non-specific chest pain with no abnormalities in cardiac magnetic resonance (CMR) examination were selected as the control group. CMR was performed within 2 weeks after the diagnosis of STEMI, as the initial reference. A plain CMR review was performed 6 months later (chronic myocardial infarction, CMI). Plain scanning includes film sequence (CINE), T2 weighted short tau inversion recovery (T2-STIR), native-T1 mapping, and T2 mapping. Enhanced scanning includes first-pass perfusion, late gadolinium enhancement (LGE), and post-contrast T1 mapping. Quantitative myocardial parameters were compared between the two groups, before and after STEMI myocardial infarction. The receiver operator characteristic curve (ROC curve) was used to evaluate the diagnostic efficacy of native-T1 before myocardial contrast enhancement and T2 values in differentiating STEMI and CMI after 6 months. RESULTS: There were no statistically significant differences in age, gender, heart rate and body mass index (BMI) between the two groups, which were comparable. The native-T1 value, T2 value and extracellular volume (ECV) were significantly higher than those in the control group [native-T1 value (ms): 1 434.5±165.3 vs. 1 237.0±102.5, T2 value (ms): 48.3±15.6 vs. 21.8±13.1, ECV: (39.6±13.8)% vs. (22.8±5.0)%, all P < 0.05]. In the experimental group, 12 patients were re-examined by plain CMR scan 6 months later. After 6 months, the high signal intensity on T2-STIR was still visible, but the range was smaller than that in the acute phase, and the native-T1 and T2 values were significantly lower than those in the acute phase [native-T1 value (ms): 1 271.0±26.9 vs. 1 434.5±165.3, T2 value (ms): 34.2±11.2 vs. 48.3±15.6, both P < 0.05]. ROC curve analysis showed that the area under the ROC curve (AUC) of native-T1 and T2 values in differentiating acute STEMI from CMI was 0.71 and 0.80, respectively. When native-T1 cut-off value was 1 316.0 ms, the specificity was 100% and the sensitivity was 53.3%; when T2 cut-off value was 46.7 ms, the specificity was 100% and the sensitivity was 73.8%. CONCLUSIONS The T2 mapping is a non-invasive method for the diagnosis of myocardial changes in patients with acute STEMI myocardial infarction, and can be used to to evaluate the clinical prognosis of patients.
Humans ; ST Elevation Myocardial Infarction/diagnosis* ; Contrast Media ; Prognosis ; Retrospective Studies ; Magnetic Resonance Imaging, Cine/methods* ; Gadolinium ; Myocardium/pathology* ; Myocardial Infarction ; Predictive Value of Tests