Objective To investigate the efficacy and safety of the minimally invasive percutaneous surgery in the treatment of thoracolumbar fracture combined with posterior ligament injury.Methods The 94 cases of thoracolumbar fracture combined with posterior ligament injury who were admitted into our hospital from Septenber 2012 to January 2016 were selected and equally divided into the observation group and the control group(47 cases in each group) according to different methods.Patients of the observation group were treated with short segment of minimally invasive percutaneous surgery,while patients of the control group were underwent single segment of minimally invasive percutaneous surgery.Recorded the outcomes and prognosis of the two groups.Results There was no significant difference in the operation time and blood loss between the two groups(P ＞ 0.05).The postoperative volume of drainage and the length of stay in the observation group were significantly shorter than those in the control group(P ＜ 0.05).The JOA score of the observation group 1 month after operation was significantly better than that of the control group(P ＜ 0.05).The incidence of complications including pedicle screw breakage,pedicle screw loosening,incision infection,and pulmonary infection in the observation group was 4.3％,which was significantly less than 21.3％ in control group (P ＜ 0.05).The Cobb's angle of the obervation group and control group 1 month after operation were (8.55 ± 1.34) ° and (16.30 ± 2.33) ° respectively,which were significantly lower than (32.19 ± 1.98) ° and (32.08 ± 2.08) ° before operation (P ＜ 0.05).And the Cobb's angle 1 month after operation in the observation group were significantly lower than that of the control group(P ＜ 0.05).Conclusion The short segment of minimally invasive percutaneous surgery for the treatment of thoracolumbar fracture combined with posterior ligament injury can reduce the incidence of postoperative complications,promote the patient's rehabilitation,correct the kyphosis and promote the recovery of neural function,which was safer and more efficient.

OBJECTIVE:To provide references for clinicians in the choice of antihypertensive drugs.METHODS:The antihypertensive efficacy 6 classes(or 15 kinds) of antihypertensive drugs in a monotherapy in the treatment of 370 patients with essential hypertension(EH) were compared.RESULTS:The blood pressure was effectively lowered by all of the antihypertensive drugs except doxazosin,and doxazosin and torasemide showed inferior efficacy in the reduction of diastolic blood pressure(DBP).CONCLUSION:Calcium antagonists with prolonged action,angiotensin converting enzyme inhibitor(ACEI),angiotens-in receptor antagonist,and the monotherapy of Terazosin or Indapamide can all effectively bring down the blood pressure.It is suggested that low-dose doxazosin and torasemide should not be used alone in treating essential hypertension.

Objective:To explore the relationship between their proficiency, needle penetration angle and the success rate of puncture by using a self-developed venipuncture angle monitor based on remote sensing technology, and measured the needle penetration angle of people with different venipuncture proficiency levels.Methods:A total of 30 sophomore medical school undergraduates without venipuncture experience and 30 nurses with more than 3 years of clinical experience each were recruited. Volunteers performed punctures on a rubber puncture model of the arm. The result of each puncture, the volunteer′s estimated insertion angle, and the actual insertion angle measured by the monitor were recorded and analyzed.Results:The puncture success rate of the nurse group was 96.7% (58/60), and the puncture success rate of the student group was 51.7% (31/60). The puncture success rate of the nurse group was higher than that of the student group( χ2 value was 29.4, P<0.05); The estimated difference of the average angle of the nurse group was (5.2 ± 1.9) °, and the estimated difference of the average angle of the student group was (8.9 ± 2.6) °. The estimated difference of the nurse group was less than the student group ( Z value was -7.10, P<0.05); the most suitable venipuncture angle range for beginners was (31.6 ± 6.4)°. Conclusions:There is a correlation between the success rate of venipuncture and the puncture angle, and optimum puncture angle for beginners in the controlled model was (31.6±6.4)°. At both skill levels, operator estimates of the puncture angle were commonly larger than the actual angle. The angle monitor based on remote sensing technology makes the precise study of venipuncture possible.

OBJECTIVETo summarize the general condition, regional distribution, prevalence and clinical characteristics of Shandong province based on hemophilia case registry information.

METHODSA retrospective study was carried out on 1979 hemophilia patients registered at Shandong Hemophilia Registration Center.

RESULTSThe 1979 cases have included 1704 hemophilia A and 275 hemophilia B patients. Hemophilia A was characterized as severe in 1021 patients (59.9%), moderate in 483 patients (28.4%), and mild in 200 patients (11.7%); while hemophilia B was characterized as severe in 125 patients (45.4%), moderate in 116 patients (42.2%), and mild in 34 patients (12.4%). The median age was 23 years (ranging from 1 month to 81 years), and most were young patients. Joint deformity occurred in 963 patients, and 948 patients had a family history of hemophilia. All counties of Shandong province had patients except for Changdao county and Fushan district of Yantai city. The prevalence of Heze city and Dongying city (3.39/100 000 and 3.05/100 000, respectively) were relatively higher.

CONCLUSIONThe above data revealed epidemiological and clinical characteristics of Shandong Province. Patient-centered registry system allowed a more detailed and accurate patient information, and promoted the comprehensive care of hemophilia, which also suggested the necessity for the establishment and improvement of the National Hemophilia Registry System.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Hemophilia A ; epidemiology ; Humans ; Infant ; Middle Aged ; Prevalence ; Registries