1.Causes and managements of postoperative neurological complications in internal fixation for the treatment of degenerative scoliosis.
Jie ZHENG ; Hong YE ; Yong-Hong YANG ; Su-Liang LOU
China Journal of Orthopaedics and Traumatology 2014;27(5):371-375
OBJECTIVETo investigate the causes and managements of postoperative neurological complications in pedicle screw internal fixation for the treatment of degenerative scoliosis (DS).
METHODSThe data of 325 patients with degenerative scoliosis underwent pedicle screw internal fixation was retrospectively analyzed from February 2000 to April 2013. There were 22 patients with postoperative neurological complications. Of them, 16 cases complicated with numbness or pain of lower limb and 6 cases with obvious sensation and motor function decreasing in lower limb. The patients were treated with trophic nerve, dehydration, glucocorticoids, reoperation according to the causes of disease. Postoperative at 3, 6 months and 1 year later, according to VAS scoring and muscule power improvement,the recovery of nerve injury was assessed.
RESULTSPostoperative at 3,6 months and 1 year later,VAS scoring of 16 patients with slightly nerve injury was 2.81 +/- 0.66, 1.94 +/- 0.77, 0.63 +/- 0.62, respectively, and the symptoms had obviously improved than 1 week after operation (P < 0.05). Postoperative at 3 months, among 6 patients with severe nerve injury,muscule power improved in 2 cases and no-improved in 4 cases, with VAS scoring of 4.83 +/- 1.17; postoperative at 6 months,muscule power still had not improved in 3 cases,with VAS scoring of 4.17 +/- 0.75; both of the VAS scoring had not significant difference than 1 week after operation (P > 0.05). One year later, there was no muscule power improvement in 2 cases,with VAS scoring of 3.00 +/- 1.26, there was significant difference than 1 week after operation (P < 0.05).
CONCLUSIONThe causes of postoperative neurological complication in internal fixation for the treatment of dengenerative scoliosis includes: dragging and torsion injury of spinal marrow and nerve root because of excessive orthopedic of scoliosis; inderect injury of nerve root because of malposition of pedicle screw; nerve functional impairment caused by spinal cord ischemia. Avoiding the above factors could decrease the complication and early discovery and treatment could decrease the adverse outcomes.
Aged ; Aged, 80 and over ; Bone Nails ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Nervous System Diseases ; etiology ; Postoperative Complications ; etiology ; Retrospective Studies ; Scoliosis ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed
2.Discussions on the management of health check-up nursing quality
Jianfang JIANG ; Liying SHEN ; Zhihong YE ; Xiaoya WANG ; Liang HONG
Chinese Journal of Hospital Administration 2010;26(10):770-772
Objective To identify the outcomes and effect of applying the health check-up nursing quality control system developed as supervised by JCI quality assessment standards.Methods The monitoring system for nursing quality in the health check-up department is established within the framework of the hospital quality improvement committee and in line with characteristics of the department.Quality improvement tools may be called into play for analysis and decision making to revolve critical problems found in health check-up nursing,upgrading nursing quality and customer satisfaction.Results Significant rise of health check-up quality and customer satisfaction for nurses,and the nurses are trained in quality control knowledge and get further involved in quality management of their department.Conclusion Health check-up nursing management system under the JCI standard is conducive to raising the nursing quality,and helps nurses with problem analysis and solution.
3.The effects of interleukin-28B gene polymorphisms on antiviral treatment response in patients with chronic hepatitis C
Yu ZHOU ; Xiaoting YE ; Wei CHEN ; Liang HONG ; Weimin JIANG
Chinese Journal of Infectious Diseases 2017;35(4):218-222
Objective To investigate the relationship between interleukin (IL)-28B gene polymorphisms (rs12979860 and rs8099917) and treatment response in patients with chronic hepatitis C in China.Methods Taqman probes single nucleotide polymorphism genotyping methods were used to detect the genotypes of rs12979860 (C/T) and rs8099917 (T/G) located at IL-28B gene in 105 included patients.The patients were treated with standard doses of pegylated interferon plus ribavirin and were followed up regularly for therapeutic response and adverse reaction.The relationship between IL-28B gene polymorphism and antiviral treatment response of patients were analyzed.Categorical data were analyzed using Pearson chi-square test or Fisher exact test.Results Totally 105 cases were included in our study and 2 cases lost to follow-up because of moving away.Eight-one cases (78.6%) of the remaining 103 patients were CC/TT genotype (CC/TT group) at rs12979860 and rs8099917, 19 cases (18.4%) were CT/TG (CT/TG group) and 3 cases (2.9%)were TT/TG (TT/TG group).No other genotypes were detected and linkage disequilibrium was discovered at the two polymorphism loci (r2=0.11).After 4 weeks of treatment, 35 cases (43.2%) in CC/TT group, 3 cases (15.8%) in CT/TG group and non in TT/TG group achieved rapid virological response (RVR).There were statistically significant differences among three groups (P=0.033).After 12 weeks of treatment, 45 cases (55.6%) in CC/TT group, 6 cases (31.6%) in CT/TG group and none in TT/TG group achieved early virological response (EVR).There were statistically significant differences among three groups (P=0.025).At the end of the treatment, 68 cases (83.9%) in CC/TT group, 10 cases (52.6%) in CT/TG group and only 1 case (33.3%) in TT/TG group achieved end-of-treatment response (ETR).There were significant statistical differences among the three groups (P=0.003).After 24 weeks of follow-up, 62 cases (76.5%) in CC/TT group, 9 cases (47.4%) in CT/TG group and 1 case (33.3%) in TT/TG group achieved sustained virological response (SVR).There were statistically significant differences among the three groups (P=0.014).One hundred and one cases in CC/TT group developed adverse events, among them 19 cases needed clinical treatment.There were 43 cases in CT/TG group developed adverse events and 9 cases needed treatment.Seven cases in TT/TG group developed adverse events and only 1 case needed treatment.There were no statistically significant difference among three groups (χ2=0.139,P>0.05).Conclusions The genotype of rs12979860 (C/T) and rs8099917 (T/G) at IL-28B gene could affect the treatment response in patients with chronic hepatitis C.RVR and SVR are higher in patients with genotype CC/TT, which might help to guide HCV treatment.
4.Psychological Rehabilitation for the Injured and Disabled Patients after Earthquake
Changfeng QI ; Songhuai LIU ; Layan ZHANG ; Zhifeng LIANG ; Ye HONG
Chinese Journal of Rehabilitation Theory and Practice 2008;14(7):680-682
The earthquake always results in a great number of the injured and disabled patients.So timely and effective psychological rehabilitation interventions are very helpful,especially for those survivors to relieve their psychological traumatic response caused by the earthquake,and renew their healthy psychological situation.The present article analyzes the chief psychological symptoms and influencing factors of the injured and disabled patients after the earthquake,and further provides some principles and strategies for the psychological rehabilitation,such as how to cope with the early stress response(anxiety,depression,self-abasement,and so on),or how to deal with the social phobia.
5.The phylogenetic evolution and genetic variations of gag gene among the prevalent human immunodeficiency virus-1 strains in Guangxi region
Rongfeng CHEN ; Bingyu LIANG ; Bo ZHOU ; Fangning ZHAO ; Jie LIU ; Hong WANG ; Minlian WANG ; Xu LI ; Li YE ; Hao LIANG
Chinese Journal of Infectious Diseases 2015;(8):485-489
Objective To study the phylogenetic evolution and genetic variations of gag gene among the prevalent human immunodeficiency virus (HIV )‐1 strains in Guangxi Zhuang Autonomous Region . Methods Plasma samples of 158 HIV‐1 infected patients in Guangxi area were collected during October 2011 to March 2012 .The gag gene fragments of HIV‐1 were amplified by reverse transcription/nested‐polymerase chain reaction and then sequenced .MEGA 5 .03 was utilized to construct phylogenetic tree and to calculate the genetic distances and selection pressures (globle ω) of gag gene and its coding regions . The comparisons between two groups were tested by Student′s t test ,and the comparisons of multiple groups were tested by one‐way ANOVA .Results A total of 140 amplification products of gag gene were obtained from 158 samples .Four subtypes of HIV‐1 were found ,including CRF01_AE (80 ,57 .1% ) , CRF08_BC (46 ,32 .9% ) ,CRF07_BC (10 ,7 .1% ) ,and subtype B (B′) (4 ,2 .9% ) .The genetic distances of gag gene of the above subtypes were 0 .036 ± 0 .001 ,0 .031 ± 0 .002 ,0 .043 ± 0 .003 and 0 .102 ± 0 .006 ,respectively ,with statistical significance (F=220 .62 ,P<0 .01) .The p17 and p24 coding regions suffered negative selection pressure (globleω<1) .Neither the globle ω in p17 region nor that in p24 region had significant differences among different subtypes (F=0 .761 ,P=0 .469 and F=0 .037 ,P=0 .964 , respectively ) . Conclusion CRF01_AE is the major subtypes of HIV‐1 in Guangxi Zhuang Autonomous Region .The coding regions of gag gene are relatively conserved during evolution .Changes of HIV‐1 prevalence ,however ,may affect the genetic variation of gag gene ,which should be continuously monitored .
6.Comparison between volar and radial column approach by plate fixation for the treatment of unstable fracture of distal radius: a Meta-analysis.
Ye-cheng LI ; Wei ZHANG ; Shou-zheng LIU ; Cheng-liang ZHANG ; Hong-jun WANG
China Journal of Orthopaedics and Traumatology 2016;29(1):21-26
OBJECTIVETo assess the clinical effectiveness of volar and radial column approach by plate fixation for the treat- ment of unstable fracture of distal radius.
METHODSAccording to Cochrane Systematic Review, Medline, Embase, Cochrane Li- brary, CNKI and CBM, randomised controlled trials (RCTs) of volar and radial column approach by plate fixation for the treat- ment of unstable fracture of distal radius were searched for from 1966 to 2014. Data analysis was performed with the Cochrane Collaboration's RevMan 5.0 software.
RESULTSTotally 391 patients of 6 RCTs and 2 retrospective cohort studys were included and divided into volar plate group (187 cases) and radial column plate group (204 cases). Meta-analysis result showed: compared with radial column plate group, volar plate group had significant difference in recovery of wrist function [SMD = 0.74, 95% CI (0.47, 1.01), P < 0.00001], Gartland-Werley scores [SMD = -1.39, 95% CI (-2.24, -0.53), P = 0.001], postoperative neural in- jury [OR = 3.67, 95% CI (1.37, 9.84), P = 0.01 1 and postoperative wrist pain [OR = 0.32, 95% CI (0.13, 0.74), P = 0.008]. But no significant difference was identified in DASH scores [SMD = -0.36, 95% CI (-0.97, 0.26), P = 0.25], radiographic result assess- ment [SMD = -0.18, 95% CI (-0.53, 0.16), P = 0.3], postoperative grip strength [SMD = 0.71, 95% CI (-0.12, 1.54),P = 0.09], postoperative tendinous damage [OR = 0.31, 95% CI (0.10, 0.98), P = 0.05] and carpal tunnel syndrome [OR = 0.96, 95% CI (0.63, 1.48), P = 0.87].
CONCLUSIONCompared with radial column plate internal fixation, volar approach plate fixation for treat- ment of distal radius intra-articular fracture has advantage of recovery of joint functionand. However, the volar approach plate fix- ation was associated with a higher risk of long-term complications than the radial column approach plate fixation.
Bone Plates ; Fracture Fixation, Internal ; methods ; Humans ; Radius Fractures ; surgery
7.Effect of acupuncture therapy on patients with low back pain: a Meta-analysis.
Fei-fan LIANG ; Wei-ye CHEN ; Bo CHEN ; Qin-guang XU ; Hong-sheng ZHAN
China Journal of Orthopaedics and Traumatology 2016;29(5):449-455
OBJECTIVETo systematically review the clinical efficacy of acupuncture on the patients with low back pain (LBP).
METHODSRandomized controlled trials (RCTs) about pure acupuncture therapy versus other treatments in treating LBP were electronically searched in PubMed, CBM, EMbase, The Cochrane Library, CNKI, VIP and Wanfang Data from January 2004 to May 2014. The observed index on the results were the changed scores of VAS, ODI, JOA and RMDQ. Two reviewers independently screened the literatures according to the inclusion and exclusion criteria, as well as the extracted data, and assessed the methodological quality. The results of Meta-analysis was conducted by RevMan 5.2 software.
RESULTSTen RCTs involved 751 patients were finally included. The results of Meta-analysis indicated that the role of pure acupuncture group in improving the VAS score was better than that of the control group, and the combined effect size was RR = -.32, 95% CI (-1.41, -1.22); Z=27.28, P<0.00001; the role of pure acupuncture group in improving the ODI score was better than that of the control group, and the combined effect size was RR = -5.07, 95% CI (-7.50, -2.65); Z=4.10, P<0.0001; the role of pure acupuncture group on improved JOA score was better than that of the control group and the combined effect size was RR=2.83, 95% CI (2.02, 3.63), Z=6.90, P<0.00001. The role of pure acupuncture group in improving the RMDQ score was better than that of the control group, and the combined effect size was RR = -2.80, 95% CI (-3.49, -2.11), Z=7.95, P<0.00001.
CONCLUSIONThe result of meta-analysis demonstrates that pure acupuncture may have a favorable effect on self-reported pain and functional limitations in LBP patients.
Acupuncture Therapy ; Humans ; Low Back Pain ; therapy ; Randomized Controlled Trials as Topic ; Treatment Outcome
8.Preparation of interferon-alpha-containing liposomes by the powder bed grinding method
Zhi-Wei YE ; Qiao-Hong HU ; Wen-Quan LIANG
Journal of Zhejiang University. Medical sciences 2002;31(6):433-436
OBJECTIVE: To investigate a nwe, simple technique for preparation of interferon-alpha-liposomes, which may be suitable for industrial use. METHODS The uniform design coupled with computerized optimization was utilized to screen the formulation and preparation procedure of interferon-alpha-liposomes. Pro-liposomes were prepared by the powder bed grinding method and combined with interferon-alpha-solution to form interferon-alpha-liposomes. Liposome size was determined by the particle size analyzer. Free interferon-alpha and interferon-alpha-liposome were separated by gel filtration. Then the recovered activity of interferon-alpha was analyzed by enzyme-linked immunosorbent assay. RESULTS The result demonstrated that the best interferon-alpha-liposome formulation was as follows: the protectant was sorbitol; weight ratio of protectant to lipid was 5:1; weight ratio of octadecytamin to lipid was 1:9; weight ratio of sobey phosphatidylcholine to cholesterol was 9:1 respectively. Interferon-alpha-liposome size determined by the particle size analyzer was 80.8+/-36 nm and the encapsulation efficiency was 59.0+/-3.3%. CONCLUSION The powder bed grinding method can be used to prepare pro-liposomes which can be easily combined with interferon-alpha-solution to form interferon-alpha-liposomes.
9.In situ investigation to three dimensional structures of Chinese medicines seeds.
Lin-Lin YE ; Yan-Ling XUE ; Liang-Hong NI ; Ti-Qiao XIAO
China Journal of Chinese Materia Medica 2014;39(14):2619-2623
This paper is aimed to microscopic identification of traditional Chinese medicines (TCMs) using an in situ imaging method. In this study, two kinds of Zingiberaceae seeds, Amomi Rotundus Fructus and Alpiniae Katsumadai Semen, were investigated by synchrotron radiation in-line X-ray phase-contrast computed tomography (IXPCT) imaging method. The results showed that the microstructures of these Zingiberaceae seeds could be clearly obtained from the virtual slices information in different observing angles. It proves that IXPCT is an effective imaging method, which can provide the imaging information for the microscopic identification of the intact TCMs in situ and non-destructively.
Amomum
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cytology
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Imaging, Three-Dimensional
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methods
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Medicine, Chinese Traditional
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Seeds
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cytology
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Tomography, X-Ray Computed
10.Detection of miR-2 1 expression levels in carcinoma tissue and serum of patients with papillary thyroid carcinoma and its significance
Minxue ZHAO ; Baiwen LI ; Lin ZHU ; Hongshan YE ; Xiaofeng TIAN ; Liang WEI ; Hong CAO
Journal of Jilin University(Medicine Edition) 2014;(6):1237-1240
Objective To investigate the expressions of miR-21 in carcinoma tissue and serum of the patients with papillary thyroid carcinoma (PTC), and to clarify its clinical significance.Methods Real-time PCR was used to detect the expression levels of miR-21 in carcinoma tissue and serum of 46 PTC patients,thyroid tissue and serum of 35 cases of nodular goiter and 18 healthy people. The correlations of miR-21 expression level with the clinicopathological features of PTC patients were analyzed.Results The relative expression levels of miR-21 in carcinoma tissue and serum of the PTC patients were 2.74±1.53 and 0.21±0.08,and they were 0.92±0.81 and 0.08±0.05 in carcinoma tissue and serum of the patients with nodular goiter,0.86 ± 0.39 and 0.07 ± 0.03 in normal papillary thyroid tissue and serum of 18 healthy people.The expression levels of miR-21 in carcinoma tissue and serum of the patients with PTC were higher than those of the patients with nodular goiter and healthy people (P<0.05).The expression level of miR-21 in serum and carcinoma tissue of PTC patients had a positive correlation with the extraglandular invasion,distant metastasis,lymph node metastasis,and TNM stages (P<0.05);and it had no correlation with gender and tumor sizes.Conclusion The expression levels of miR-21 in carcinoma tissue and serum of the PTC patients are increased. The up-regulated expression of serum miR-2 1 is correlated with the clinicopathological features of PTC patients, which indicates that miR-2 1 could be used as a potential marker for early detection of PTC.