ObjectiveTo observe the effect of the designed cervical orthosis(CO) and the finished collar in the treatment of vertebroarterial cervical spondylopathy.Methods70 patients with vertebral artery type cervical spondylosis were divided into designed cervical orthosis group (35 casese) and the finished collar group (35 casese) separately.ResultsThe excellent and good rate of the designed cervical orthosis group was 94-3% while that of the finished collar group was 71-4%. There was significant difference between the two groups after 4 weeks of treatment(P<0-01).ConclusionThe designed cervical orthosis(CO) in the treatment of vertebroarterial cervical spondylopathy is more effective than finished collar.

Objective:To analyze the effect and safety of blood glucose fluctuation in brittle diabetes treated with intensive insulin therapy combined with sodium-glucose transporter 2 inhibitor.Methods:Ninety-eight patients with brittle diabetes in Shenzhen Longhua District People's Hospital were selected from May 2017 to May 2019. They were divided into two groups by random number table, 49 cases in each group. The control group was treated with intensive insulin therapy combined with saglitine, while the observation group was treated with intensive insulin therapy combined with sodium-glucose transporter 2 inhibitor. Following up for 12 weeks, the plasma glucose and blood glycemic variations, insulin dosage, plasma 8-iso-prostaglandin F2α, hypersensitive C-reactive protein and safety related indicators were compared between the two groups before and after treatment.Results:Compared with the control group, the standard deviation of blood glucose [(1.8±0.5)mmol/L vs (6.5±1.4)mmol/L, t=7.235], large amplitude glycemic excursions [(6.5±1.1)mmol/L vs (17.3±4.7)mmol/L, t=13.446], postprandial glucose excursion [(1.2±0.4)mmol/L vs (9.2±2.0)mmol/L, t=8.921], inter-quartile range [(3.7±1.1)mmol/L vs (12.4±4.2)mmol/L, t=7.003], means of daily difference [(1.5±0.4)mmol/L vs (4.6±0.8)mmol/L, t=4.537] in the observation group were significantly decreased ( P<0.05), and the levels of plasma 8-iso-prostaglandin F2α [(7.8±1.2)ng/L vs (13.6±2.3)ng/L, t=4.882], hypersensitive C-reactive protein [(5.2±1.3)mg/L vs (8.7±1.3)mg/L, t=4.406], insulin dosage [(30.9±10.2)U/d vs (42.3±13.4)U/d, t=5.726] and body mass index [(18.3±1.2)kg/m 2 vs (21.0±2.3)kg/m 2, t=4.135] also decreased significantly ( P<0.05), and the incidence of hypoglycemic events [16.3%(8/49) vs 36.7%(18/49), χ 2=9.697] and severe hypoglycemia [0 vs 14.3%(7/49), χ 2=7.268] decreased significantly ( P<0.05). Conclusions:Combination of dapagliflozin and intensive insulin therapy can significantly improve glucose metabolism in brittle diabetes, and reduce insulin dosage and hypoglycemic events.

Objective To study the use of early bile duct to bile duct end-to-end(side) anastomosis for extrahepatic bile duct injuries.Methods The clinical data of 25 patients with extrahepatic bile duct injuries with early bile duct to bile duct end-to-end(side) anastomosis were retrospectively analyzed.Results Bile duct injuries happened in laparoscopic cholecystectomy (n=17),laparoscopic exploration of common bile duct (n=1),laparotomy (n=5),and knife wound (n=2).All of the repairs were successfully carried out.Except for one patient who was lost to follow-up,the other patients were followed for over 2 years.There was no bile duct stenosis.One patient died after 5 months of repair in other hospital because of a recurrent bile duct calculus.Conclusions Early bile duct to bile duct end-to-end(side) anastomosis had a good long-term results.The operation needs to be done by a good surgeon or supervised by an experienced specialist in biliary surgery.A prolonged period of T tube stenting is a prerequisite for success.

BACKGROUND:There are controversies about preserving the remnant in the anterior cruciate ligament reconstruction procedure because of its uncertain therapeutic effects.
OBJECTIVE:Tocompare the efficacy and safety of preserving-remnant with removing-remnant for arthroscopic anterior cruciate ligament reconstruction using a meta-analysis.
METHODS:A computer-based online search was conducted in PubMed,Embase,the Cochrane Library, CDSR, CBM, and CNKI databases by using the English key wordsof “anterior cruciate ligamentAND remnant (OR stump)ANDrandomized controled trial (RCT)ORquasi-RCT” and the Chinese key words of“anterior cruciate ligament reconstruction, preserving-remnant, removing-remnant” to screen the relevant articles publishedfrom 1995 to July 2015. Meta-analysis was performed using Review Manager 5.3 software.
RESULTS AND CONCLUSION:A total of 13 randomized controled trials were included. The meta-analysis resultsshowed that there were no statisticaly significant differences in KT1000/2000 scores (OR=-0.28, 95%CI:-0.76-0.20,P=0.25), the good rate of synoveal coverage (OR=-0.30, 95%CI:-0.30-0.90,P=0.32), and the incidence of cyclops leions (OR=0.87,95%CI: 0.63-2.90,P=0.44). Postoperative Lysholm scores (OR=2.45, 95%CI: 0.52-4.39,P=0.01), proprioceptive function (OR=-1.72, 95%CI:-3.32 to 0.13,P=0.03), tunnel enlargement (OR=-0.66, 95%CI:-1.08 to-0.23,P=0.002) in preserving-remnant were superior to removing-remnant for arthroscopic anterior cruciate ligament reconstruction. These results suggest that both preserving-remnantandremoving-remnant for arthroscopic anterior cruciate ligament reconstructioncanobtain satisfactory antero-posterior stability of the knee. Preserving-remnant exhibits superiority in post-operative scores of the knee, proprioceptive function, tunnel enlargement.Furtherhigh-quality randomized controled trials are warranted because of some low-quality studies and the existing biases.

Objective To study factors associated with necrosis and calcification of cyst echinococcosis. Methods This study retrospectively analyzed 191 cases of hepatic cycstic echinococcosis admitted from 2005 to 2008 in the First Affiliated Hospital of Xinjiang Medical University Department of General Surgery, possible relevant factors screened were the patients' gender, age, operation frequency, hepatitis, gall stones, calcium of blood serum, multiple hepatic hydatid cyst, biliary fistulae and hepatic cycstic echinococcosis degeneration. Single-factor analysis and multi-factors analysis were conducted. Results The single-factor independent samples t-test showed that age is significantly related to hepatic cycstic echinococcosis degeneration (t = - 2. 455, P = 0. 008). Single factor Chi-square test showed that factors impacting on hepatic cycstic echinococcosis degeneration were multiple hepatic hydatid cyst and the biliary fistulae (x2 = 6. 848, P = 0. 009; x2 = 7. 149, P = 0. 008). The multiple-factor Logistic regression analysis showed that the age, the multiple hepatic hydatid cyst, and biliary fistulae are the related risk factors(x2 =5. 306,P = 0. 021,OR = 1. 665;x2 = 10. 377,P =0. 001,OR =3. 300;x2 = 4.455,P =0. 035, OR =2. 164) of hepatic cycstic echinococcosis patients with cyst echinococcosis degeneration. Conclusions Age, multiple hepatic hydatid cyst and biliary fistulae are the risk factors associated with degenerative necrosis and calcification of hepatic echinococcosis.

Humans ; Minimally Invasive Surgical Procedures ; Neurosurgery ; methods

[Objective] To discuss the clinical significance of simple synovial tuberculosis treated and diagnosed by arthroscopy. [Methods] A review study of 8 patients with simple synovial tuberculosis from September 1998 to September 2004. The 8 cases with the main clinical manifestation of articular swelling were confirmed as simple synovial tuberculosis by arthroscopic examination and arthroscopic synovectomy in pathology. [Results] The 8 cases were definitely diagnosed by arthroscopy pathologically. The average follow-up period was two years and four months. For all of the 8 cases, the articular symptoms disappeared, articular function recovered well and the therapeutic effect was satisfactory. [Conclusion] Arthroscopic examination is an effective method to diagnose synovial tuberculosis at early stage. Synovectomy with arthroscopy can remove the pathological synovial membrane and is beneficial to the control of the local tubercular focus.

Objective To assess the characteristics of heart rate turbulencer (HRT) in elderly patients with decreased left ventricular diastolie function.Methods 40 patients were divided into two groups:20 patients with enlarged left atrium and 20 patients without enlarged left atrium.20 healthy people were selected as controls. Turbu1ence onset (TO) and turbulence slope (TS) were measured,and correlation was analyzed between TO,TS and the E/A,index of Macruz and heart rate variability (HRV).Results TO was higher (P<0.05) and TS was lower in patients (P<0.01),TO was higber in patients with enlarged left atrium than in with out enlarged lef atrium people (P<0.05) and TS was lower (P<0.01).TO was positively (P<0.01) and TS Was negatively (P<0.05),correlated with the index of Macruz.TO Was negatively (P<0.05) and TS was positively (P<0.05) related to SDNN and SDANN.Conclusion HRT can be used as a potential risk predictor in decreased left ventricular diastolic function patients.

Objective To explore the effects of the cervical vertebra rehabilitation gymnastics on patients with different types of cervical spondylosis (CS). Methods 203 patients with different types of CS were selected. They were trained with rehabilitation gymnastics. The electrophysiological examination of neck-shoulder muscles were used to evaluate the effects 3 and 6 months after training. Results The peak of electrophysiological action potential of neck- shoulder muscles was significantly different in all the types of CS patients (P<0.001), as well as the conduction velocity of action potential (P<0.05) before and 3, 6 months after training. There was significantly different in scores of subjective symptoms in sympathetic cervical spondylosis and cervical spondylotic radiculopathy patients (P<0.001), but was not in the other types (P>0.05) before and 3, 6 months after training. Conclusion The cervical vertebra rehabilitation gymnastics can promote blood circulation of neck-shoulder muscles, relieve muscle spasm and ease the symptoms, especially for patients with cervical spondylotic radiculopathy and sympathetic cervical spondylosis.

Objective To investigate the application of fusion imaging in the initial prostate biopsy.Methods Retrospective analysis was made on 40 patients who underwent initial ultrasound-guided prostate biopsy in Shanghai Jiao Tong University Affiliated 6th People's Hospital from August 2014 to May 2015.All patients underwent preoperative magnetic resonance imaging (MRI) scans one week prior to surgery and the results showed that all patients had suspicious positive prostate cancer lesions,while there were no positive findings in the same area in sonography.All patients with prostate cancer have been confirmed by pathologic examination.Image fusion technology was used to guide the biopsy of lesions which were suspected as prostate cancer by MRI,and then the prostate underwent systematic biopsy by 10 needles under the guide of ultrasound.R× C Chi-square test was used to compare the positive ratio among imaging fusion biopsy,systematic biopsy and combined method in the diagnosis of prostate cancer.Fourfold table Chi-square test was used to compare to undetected rate between fusion imaging biopsy and systematic biopsy in the diagnosis of prostate cancer.The differences of detection rate in the Gleason score more than 7 points of prostate cancer between fusion imaging biopsy and systematic biopsy was compared by Fisher exact test.Results In this group of 40 patients with prostate biopsy,14 cases (35.0％) were diagnosed prostate cancer by systematic biopsy,19 cases (47.5％) were diagnosed prostate cancer by image fusion biopsy,and 22 cases (55.0％) were diagnosed prostate cancer by systematic biopsy combined with image fusion.The difference of diagnostic positive rate among combined method of biopsy,image fusion biopsy and systematic biopsy had not statistically significant (P ＞ 0.05).Three cases (13.6％,3/22) of prostate cancer patients were missed in image fusion method group,and 8 cases (36.4％,8/22) of prostate cancer patients have not been diagnosed by systematic biopsy,which indicated the umdetected rate of systematic biopsy is higher than that of image fusion biopsy in prostate cancer diagnosis,and there was a statistical difference between the two groups (x2=8.338,P=0.005).Among 19 cases of prostate cancer patients who were diagnosed by image fusion biopsy method,Gleason score were greater than 7 points in 15 cases (78.9％,15/22).Among 14 cases of prostate cancer patients who were diagnosed by systematic biopsy method,Gleason score were greater than 7 points in 6 cases (42.9％,6/14).The positive rate of Gleason score ≥ 7 points in fusion imaging biopsy was higher than that of systematic biopsy,which had a statistical difference (Fisher exact probability method,P=0.039).Conclusion Image fusion method can be used to reduce the tndetected rate of prostate cancer and improve the detection rate of the high-grade prostate cancer.