1.Clinical effects of Solifenacin on female overactive bladder symptoms secondary to uncomplicated lower urinary tract infection
Bo LIAO ; Xianzhong DENG ; Yugen LI ; Xiaobin CHEN ; Xiaodong YU
The Journal of Practical Medicine 2015;31(23):3941-3943
Objective To study the efficacy and safety of Solifenacin on female overactive bladder (OAB) symptoms secondary to uncomplicated lower urinary tract infection. Methods Seventy-three adult female patients who had clinically diagnosed as OAB symptoms secondary to uncomplicated lower urinary tract infection were randomly divided into treatment group (41 cases) and control group (32 cases). Treatment group received Solifenacin , 5 mg orally qd , as well as OAB behavioral therapy , but control group was given only OAB behavioral therapy. The overactive bladder syndrome score (OABSS) was evaluated before and after antibiotic treatment in all the patients , and the treatment or observation time lasted four weeks after the antibiotic treatment were deactivated. Then OABSS scoring and the cure rate between two groups were compared. Results OABSS score of treatment group decreased significantly after receiving Solifenacin treatment one week , and the cure rate reached 56.10%, and two weeks later, the cure rate reached 92.68%. OABSS score of control group had no significant change one week after treatment and the cure rate was only 6.25%, but at the fourth week OABSS had decreased significantly and the cure rate reached 37.50%, which was still significantly lower than that of treatment group. There were no drug adverse events during treatment in both groups. Conclusions There is obvious clinical effect of solifenacin on female OAB symptoms secondary to uncomplicated lower urinary tract infection, which is safe and could significantly shorten the course of treatment.
2.A buttress plate combined with Kirschner wires for Regan-Morrey type Ⅱ coronoid fracture in elbow terrible triad injury
Jinglei XU ; Xue BAI ; Chenyang XU ; Junsen DENG ; Ning CHANG ; Wanpo MIAO ; Xianda YI ; Xianzhong MA
Chinese Journal of Orthopaedic Trauma 2021;23(5):439-442
Objective:To evaluate the curative efficacy of a buttress plate combined with Kirschner wires for treatment of Regan-Morrey type Ⅱ coronoid fracture after elbow terrible triad injury.Methods:A retrospective study was conducted of the 20 patients who had been surgically treated for Regan-Morrey type Ⅱ coronoid fracture after elbow terrible triad injury from August 2014 to August 2018 at Department of Pelvic Trauma, Henan Luoyang Orthopedic-Traumatological Hospital. They were 12 men and 8 women, aged from 18 to 60 years (average, 39 years), with 6 left and 14 right sides affected. All the coronoid fractures were fixated with Kirschner wires plus a buttress plate through the anterior approach, the radial head and lateral collateral ligaments (LCL) were repaired through the posterolateral approach, and the medial collateral ligament (MCL) was repaired or fixated with a hinged external fixator if necessary. The curative efficacy was evaluated at the last follow-up by range of motion (ROM) of the elbow, Mayo elbow performance score (MEPS), American Shoulder and Elbow Surgeons Scale (ASES) and radiographs of the elbow. Complications were also recorded.Results:The mean follow-up time was 18 months (from 12 to 24 months) and the mean healing time 5 months. At the last follow-up, ROM in flexion and extension of the affected elbow joint averaged 132.5°, ROM in elbow pronation-supination 150°, MEPS 88, and ASES 87. No subluxation or dislocation occurred after elbow surgery. The fracture of coronoid process was slightly displaced in one case but eventually healed without affecting any elbow function; fat liquefaction occurred around the posterolateral incision in 2 cases but healed after debridement; traumatic arthritic changes occurred in 5 patients but no significant dysfunction of the elbow was observed.Conclusion:A buttress plate combined with Kirschner wires can lead to fine curative efficacy for Regan-Morrey type Ⅱ coronoid fracture after elbow terrible triad injury.
3. Evaluation on case/problem-based and interactive teaching mode in pathophysiology curriculum
Sipin TAN ; Zihui XIAO ; Zizhi TU ; Kangkai WANG ; Ying LIU ; Bimei JIANG ; Gonghua DENG ; Huali ZHANG ; Xianzhong XIAO
Chinese Journal of Medical Education Research 2019;18(9):884-888
Objectives:
To provide new ideas on how to shift students' learning attitude from passive learning to active learning, we explored and evaluated a case/problem-based and interactive teaching mode in pathophysiology curriculum.
Methods:
Case/problem-based and interactive teaching mode is an innovative teaching model adopted in pathophysiology curriculum for grade 2015 students of 5-year program in clinical medicine and other medical students of non-clinical majors in Xiangya Medical School, Central South University. The teaching effectiveness of the case/problem-based and interactive teaching mode was evaluated by questionnaire survey, with 460 medical students enrolled in the survey whose approval degree on current teaching mode was analyzed. Excel was used to collect and process data, complete descriptive analysis and calculation of the percentage of indicators.
Results:
A total of 460 anonymous questionnaires were distributed and 453 valid questionnaires were retrieved, from which the following information was obtained: ① Pre-class learners' guidance designed for current teaching mode: 88.7% of students (402/453) believed that "Pre-class Learners' Guidance" motivated them to preview relevant teaching contents before class. 82.8% of students (375/453) believed "Pre-class Learners' Guidance" improved discussion quality in class. 76.6% of students (347/453) believed "Pre-class Learners' Guidance" expanded thinking and exploring space, while it did not increase student study burden (306/453, 67.6%). ② Compared with traditional teaching mode, the case/problem-based and interactive teaching mode had following advantages: It's helpful to cultivate students' clinical thinking (414/453, 91.4%), strengthen students' memory and understanding during study (400/453, 88.3%), attract students' attention in class (380/453, 83.9%), and aroused student's interest in class discussion (327/453, 72.2%). ③ 83.4% of students (379/453) preferred current teaching mode: they believed this teaching mode could improve students' ability to analyze and solve problems (325/453,71.7%), train clinical thinking (321/453, 70.9%), improve students' self-study ability (247/453, 54.5%) and increase students' capabilities of making summary and conclusion (197/453, 43.5%).
Conclusion
Case/problem-based and interactive teaching mode in pathophysiology curriculum enhances students' ability of self-studying, activates classroom's atmosphere, improves teaching quality, and effectively fosters students' clinical thinking. Therefore, this teaching mode deserves to be spread and applied in classroom teaching of pathophysiology and other basic medicine disciplines as well.
4.Minimally invasive three-window incision and novel anatomical locking plate for treatment of calcaneal fractures
Ning CHANG ; Jinglei XU ; Chenyang XU ; Junsen DENG ; Wanpo MIAO ; Xianda YI ; Xianzhong MA
Chinese Journal of Orthopaedic Trauma 2021;23(10):871-876
Objective:To investigate the efficacy of a minimally invasive three-window incision and internal fixation with a novel anatomical locking plate in the treatment of calcaneal fractures.Methods:A retrospective analysis was performed of the 46 patients with calcaneal fracture (Sanders typeⅡ and Ⅲ) who had been admitted to Department of Orthopedics, Luoyang Orthopaedic Hospital of Henan Province from February 2015 to May 2017. They were 22 males and 24 females, aged from 19 to 59 years (average, 39.0 years) and with 16 left and 30 right sides affected. They were all treated with a minimally invasive three-window incision and internal fixation with a novel anatomic locking plate. Their B?hler and Gissane angles, and height, width and length of the calcaneus were compared between preoperation, immediate postoperation and the last follow-up. Their ankle-hindfoot functions were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) scoring scale at the last follow-up; their complications were recorded.Results:All the 46 patients were followed up immediately after operation and for 14 to 18 months (mean, 16 months). All the fractures achieved bony union after an average of 3 months (from 2 to 4 months). At immediate postoperation and at the last follow-up, their calcaneal B?hler angles (34.20°±3.62° and 34.05°±3.65°) and Gissane angles (131.45°±6.04° and 131.25°±5.88°), and calcaneal heights [(41.05±2.76) mm and (40.90±2.86) mm], widths [(25.65±1.53) mm and (25.55±1.64) mm] and lengths [(76.82±1.70) mm and (76.73±1.78) mm] were significantly improved compared with the preoperative values [10.55°±7.51°, 95.32°±12.16°, (26.10±4.54) mm, (37.71±3.42) mm and (65.91±2.10) mm] ( P<0.05). There were no significant differences in the above indexes between immediate postoperation and the last follow-up ( P>0.05). According to AOFAS ankle-hindfoot scores at the last follow-up, the efficacy was evaluated as excellent in 28 cases, as good in 12 cases and as fair in 6 cases, yielding an excellent and good rate of 87.0%. No incision infection occurred after operation. Conclusion:In the treatment of calcaneal fractures of Sanders type Ⅱ and Ⅲ, the minimally invasive three-window incision and internal fixation with the novel calcaneal anatomical locking plate can achieve satisfactory reduction and rigid fixation, effectively reducing postoperative incision complications.
5.Anatomical locking plate versus common reconstruction plate in the treatment of acetabular posterior wall fracture
Ning CHANG ; Jinglei XU ; Chenyang XU ; Junsen DENG ; Xianda YI ; Wanpo MIAO ; Xue BAI ; Xianzhong MA
Chinese Journal of Orthopaedic Trauma 2021;23(12):1018-1024
Objective:To compare the curative effects between anatomic locking plate and common reconstruction plate in the treatment of acetabular posterior wall fracture.Methods:The 50 patients with acetabular posterior wall fracture were retrospectively analyzed who had been admitted to Department of Pelvic Trauma Surgery, Luoyang Orthopaedic Hospital of Henan Province from February 2015 to February 2020. They were assigned into 2 groups according to different internal fixation methods. In the reconstruction plate group of 24 patients whose fractures were fixated by a common reconstruction plate from February 2015 to June 2017, there were 21 males and 3 females with an age of (38.9±10.9) years. In the anatomical plate group of 26 patients whose fractures were fixated by an anatomic locking plate between July 2017 and February 2020, there were 20 males and 6 females with an age of (38.0±10.0) years. The 2 groups were compared in terms of operation time, intraoperative blood loss, reduction quality, hip function and complications at the last follow-up.Results:There was no significant difference in the preoperative general data between the 2 groups, indicating the 2 groups were comparable ( P>0.05). The 50 patients were followed up for 18 to 26 months (mean, 22 months). The operation time [(132.8±8.6) min] and intraoperative blood loss [(357.0±14.7) mL] in the anatomic plate group were significantly less than those [(177.2±5.9) min and (492.0±17.6) mL] in the reconstruction plate group( P<0.05). Postoperative CT examination showed that 96.2% (25/26) of the patients in the anatomical plate group and 91.7% (22/24) of the patients in the reconstruction plate group had a fracture step ≤3 mm, showing no significant difference ( P>0.05). At the last follow-up, the excellent and good rate by Harris hip score was 92.3% (24/26) in the anatomic plate group, significantly higher than that (66.7%, 16/24) in the reconstruction plate group ( P<0.05). The incidence of complications was 3.8% (1/26) in the anatomic plate group, significantly lower than that [29.2% (7/24)] in the reconstruction plate group ( P<0.05). Conclusion:Anatomical locking plate is better than common reconstruction plate in the treatment of acetabular posterior wall fracture.
6.Unilateral ureterocutaneous fistula after orthotopic ileal neobladder: a case report and literature review
Zhen TU ; Xuesong YANG ; Xianzhong DENG
Journal of Modern Urology 2024;29(5):450-452
【Objective】 The main points of diagnosis and treatment of ureterocutaneous fistula after in situ bladder operation were discussed based on clinical data and literature. 【Methods】 This report presents the data of a patient who developed a ureterocutaneous fistula 10 years after an in situ bladder procedure at Yuechi County People’s Hospital. 【Results】 A 77-year-old male underwent laparoscopic cystectomy with orthotopic ileal neobladder for bladder cancer.The case manifested as fluid leakage from the original surgical incision, initially misdiagnosed as abdominal wall sinus.After right nephrectomy due to non-functional kidney, the fistula healed. 【Conclusion】 Ureterocutaneous fistulas are commonly associated with kidney transplantation and postoperative complications of upper urinary tract such as calculi and xanthogranulomatous pyelonephritis.Fistulography can be conclusive for this condition.Prompt identification and repair of urinary tract injuries are crucial.