OBJECTIVETo evaluate the clinical effects of dynamic neutralization system (K-Rod) in treating multisegmental lumbar degenerative disease.

METHODSFrom October 2011 to October 2013, 20 patients with multisegmental lumbar degenerative disease were treated with dynamic neutralization system (K-Rod). There were 8 males and 12 females with an average age of 45.4 years old (ranged from 31 to 65) and an average course of 3.8 years (ranged from 9 months to 6.25 years). All patients had the history of low back and legs pain. Among them, 10 cases were far lateral lumbar disc herniation, 7 cases were lumbar spinal stenosis, 3 cases were lumbar spondylolisthesis (degree I in 2 cases and degree II in 1 case). Every patient had only one responsible segment which causing the symptom would have to be rigidly fixed during operations, and the adjacent intervertebral disc of the responsible segments at least 1 segment has already obvious degenerated. All patients underwent the operation to relieve compressed nerves and reconstruct spinal stability with K-Rod system (the responsible segments were fixed with interbody fusion, and the adjacent segments were fixed with dynamic stabilization). Visual analogue scale (VAS), Japanese Orthopaedic Association Scores (JOA) and Oswestry Disability Index (ODI) were used to evaluate the clinical effects. Imaging data were used to analyze the range of motion (ROM), intervertebral disc height and intervertebral disc signal (according to modified Pfirrmann grading system) in degenerative adjacent segment.

RESULTSAll patients were followed up for more than 1 year, and preoperative symptoms obviously relieved. There were significant differences in VAS, JOA, ODI between preoperative and postoperative (postoperative at 1 week and 1 year) (P<0.05). Radiological examination showed that all responsible segments had already fused, and no looseness, displacement and breakage of internal fixations were found. Postoperative at 1 year, the ROM of adjacent segments were decreased (P<0.05). There was no significant difference in intervertebral disc height between preoperative and postoperative at 1 year (P>0.05). According to modified Pfirrmann grading system to classification for the 25 disks of adjacent segment, 8 disks (32%) got improvement, 15 disks (60%) got no change and 2 disks (8%) got aggravation at 1 year after operation.

CONCLUSIONDynamic neutralization system (K-Rod) combined with interbody fusion could obtain short-term clinical effects in the treatment of multisegmental lumbar degenerative disease.

Adult ; Aged ; Female ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Range of Motion, Articular ; Spinal Diseases ; surgery ; Spinal Fusion ; methods ; Spinal Stenosis ; surgery ; Spondylolisthesis ; surgery

OBJECTIVETo explore effects of electroacupuncture of different frequencies on stroke.

METHODSForty-seven cases of stroke were treated with electroacupuncture at the motor region of the scalp and divided into 2 Hz, 2/15 Hz and 100 Hz groups according to the used frequency. Cerebral blood perfusion and brain functions before and during electroacupuncture in the 3 groups were investigated with single photon emission computed tomography (SPECT).

RESULTSLocal cerebral blood perfusion and brain cell functions could be improved by electroacupuncture of the 3 frequencies, and the actions of 2/15 Hz and 100 Hz were better.

CONCLUSIONElectroacupuncture of 2/15 Hz and 100 Hz has a better therapeutic effect on stroke when the stimulating intensity is fixed.

Brain ; Electroacupuncture ; Humans ; Nervous System Physiological Phenomena ; Stroke ; Tomography, Emission-Computed, Single-Photon

Objeetive To discuss the correlation of creatinine reduction ratio(CRR2)from posttransplant day 1 to day 2 and early graft function recovery status after kidney transplantation. Methods Clinical data of 80 patients after renal transplantation from Jan 2005 to Mar 2007 were retrospectively analyzed.Patients were divided into three groups according to the post-operative serum creatinine level:53 patients within IGF group[cereatinine＜265.2 μmol/L by post-operative day(POD)no.5],14 patients within SGF group(creatinine＞265.2 μmol/L on POD no.5,but no need for dialysis),and 13 patients within DGF group(need for dialysis in the first week post-transplant).Then the value and 99%CI of CRRz of these three groups were calculated. Results The value of CRR2 of IGF,SGF and DGF was(46.8±14.6)%,(25.6±13.5)%and(0.7±17.7)%respectively.And CRR2 99%CI of IGF,SGF and DGF was 41%-52%,15%-36%and-14%-16 0A respectively.There was significant difference in the value of CRR2 among IGF,SGF and DGF group.So a criteria for early diagnosis of IGF,SGF and DGF by CRR2 99%C1 was established:IGF(CRR2≥40%),SGF (15%＜CRR2＜40%)and DGF(CRR2≤15%). Conclusion CRR2 has a good correlation with early graft function recovery after kidney transplantation,and can be used to predict the occurrence of SGF and DGF.

OBJECTIVETo evaluate the beneficial effects of application of a self-designed reciprocating gait orthosis (RGO) combined with comprehensive rehabilitation training on bladder and bowel function in paraplegic patients sustaining spinal cord injuries (SCI).

METHODSTwelve paraplegic patients with complete spinal cord injury at the levels between T(4) and L(1) received the RGO with a comprehensive rehabilitation exercise program carried out before and after fixing. Cold water and colon excretion tests were performed before and 3 months after application of the RGO, and the bladder volume, residue bladder volume, and bladder and bowel pressures were measured in these patients.

RESULTSThe 12 paraplegic patients all showed positive results in cold water test before and after RGO application. Before RGO application, 11 of these patients were positive for urine bacteria and only 1 patient was still positive 3 months after the application. The bladder volume and bowel pressure of the patients were significantly increased (P<0.05), while the residue volume and pressure of the bladder were significantly reduced 3 months after RGO application (P<0.05).

CONCLUSIONRGO combined with comprehensive rehabilitation training can effectively improve the bladder and bowel function and the quality of life of patients with complete spinal cord injury, suggesting much clinical value for its extensive application.

Adult ; Female ; Humans ; Intestines ; physiopathology ; Male ; Middle Aged ; Orthotic Devices ; Paraplegia ; etiology ; physiopathology ; rehabilitation ; Spinal Cord Injuries ; complications ; Urinary Bladder ; physiopathology ; Walkers ; Young Adult

OBJECTIVETo evaluate the effect of wound closure tension on the blood flow of the expanded pedicled fasciocutaneous flap, so as to find the best tension for the blood supply of the flap.

METHODS8 piglets, aged 9-12 months, were used. On each side of pig back, a cephalic based expanded fasciocutaneous flap was designed. The size of the flaps was 5 cm x 20 cm. In the control group, the flaps were not elevated (0 g tension). In the experimental group, the flaps were treated at the end with the tension of 100, 200, 300, 400, 500, 600, 700, 800, and 900 g after elevation. The blood oxygen saturation (StO2) of the flaps was measured under different wound closure tension.

RESULTSThe flap StO2 raised along the increase of tension until the tension reached 200-300 g. Then the flap StO2 decreased when the tension continued to increase above 200-300 g.

CONCLUSIONSThe tension of 200-300 g is good for the blood flow of expanded pedicled fasciocutaneous flap. So the flap flexibility can be best used and the complication can be avoided.

Animals ; Surgical Flaps ; blood supply ; Sus scrofa ; Swine ; Tensile Strength

Biomarkers ; Humans ; Muscular Atrophy, Spinal/genetics*

The current situation of deep learning applied to single-and multi-lead ECG detection of arrhythmia was reviewed.The problems of deep learning during the application in generalization,interpretability and time complexity were analyzed,and the countermeasures were put forward accordingly.It's pointed out deep learning would be applied widely in arrhythmia ECG detection with the development of the algorithm,dataset and hardware.[Chinese Medical Equipment Journal,2024,45(2):105-112]

Objective:To compare clinical characteristics and results on parameters for muscle measurement in elderly sarcopenia patients of different age groups.Methods:This was a cross-sectional study, and 404 outpatients aged 60 years and over were enrolled and received a long-term follow-up.According to the World Health Organization classification of the elderly, the subjects were divided into a youngest-old group, a middle old group and an oldest-old group; and according to the diagnostic criteria of the Asian Working Group for Sarcopenia in 2019, elderly people of all ages were divided into a sarcopenia group and a non-sarcopenia group.General clinical data were recorded, and the upper arm circumference, leg circumference, skeletal muscle index, grip strength and walking speed, the Short Physical Performance Battery and timed up and go were conducted.At the same time, the body composition was measured by multifrequency bioelectrical impedance analysis.Results:The subjects had a mean age of(85.24 ± 8.23)years, including 90(22.28%)youngest-old, 165(40.84%)middle old and 149(36.88%)oldest-old.123 patients(30.45%)were diagnosed with sarcopenia, with a prevalence of 27.78%(25)in the youngest-old group, 28.48%(47)in the middle old group and 34.23%(51)in the oldest-old group.Compared with those without sarcopenia, the basal metabolic rate in sarcopenia patients of all age groups decreased significantly, the levels of hemoglobin and albumin in youngest-oldsarcopenia patients decreased, the waist circumference and body mass index in middle old and oldest-old sarcopenia patients decreased, and the body fat rate in middle old sarcopenia patients increased.In the subjects with sarcopenia, the proportion of men in the oldest-old group was higher than in the other two groups.Compared with the youngest-old group, the levels of alanine aminotransferase and prealbumin decreased, serum creatinine increased, and skeletal muscle index values did not change in the middle old and longest-old groups, but handgrip strength(27.7±5.9 vs.23.2±6.9 vs.21.4±5.8, F=5.81, P=0.004), gait speed(0.8±0.2 vs.0.7±0.2 vs.0.5±0.2, F=11.88, P=0.000)and calf circumference(33.4±3.3 vs.15.9± 8.4 vs.31.5±3.1 vs.30.9±3.3, F=3.58, P=0.031)significantly decreased, and time up and go values(10.0±2.1 vs.15.9±8.4 vs.20.8±12.8, F=6.98, P=0.001)increased in the middle old and longest-old groups.Partial correlation analysis showed that age had a significant negative correlation with handgrip( r=-0.374, P=0.001), daily gait speed( r=-0.441, P=0.000), and calf circumference( r=-0.223, P=0.017), but a significant positive correlation with timed up and go( r=0.319, P=0.009). Conclusions:Compared with youngest-old sarcopenia patients, middle old patients show significant decline in muscle function, muscle strength and muscle mass in the lower limb.With increasing age, the impact of changes in muscle function, muscle strength and regional muscle mass on adverse events should receive heightened attention.

Background:For Chinese patients with hepatocellular carcinoma (HCC),surgical resection is the most important treatment to achieve long-term survival for patients with an early-stage tumor,and yet the prognosis after surgery is diverse.We aimed to construct a scoring system (Shanghai Score) for individualized prognosis estimation and adjuvant treatment evaluation.Methods:A multivariate Cox proportional hazards model was constructed based on 4166 HCC patients undergoing resection during 2001-2008 at Zhongshan Hospital.Age,hepatitis B surface antigen,hepatitis B e antigen,partial thromboplastin time,total bilirubin,alkaline phosphatase,γ-glutamyltransferase,α-fetoprotein,tumor size,cirrhosis,vascular invasion,differentiation,encapsulation,and tumor number were finally retained by a backward step-down selection process with the Akaike information criterion.The Harrell's concordance index (C-index) was used to measure model performance.Shanghai Score is calculated by summing the products of the 14 variable values times each variable's corresponding regression coefficient.Totally 1978 patients from Zhongshan Hospital undergoing resection during 2009-2012,808 patients from Eastern Hepatobiliary Surgery Hospital during 2008-2010,and 244 patients from Tianjin Medical University Cancer Hospital during 2010-2011 were enrolled as external validation cohorts.Shanghai Score was also implied in evaluating adjuvant treatment choices based on propensity score matching analysis.Results:Shanghai Score showed good calibration and discrimination in postsurgical HCC patients.The bootstrap-corrected C-index (confidence interval [CI]) was 0.74 for overall survival (OS) and 0.68 for recurrence-free survival (RFS) in derivation cohort (4166 patients),and in the three independent validation cohorts,the CIs for OS ranged 0.70-0.72 and that for RFS ranged 0.63-0.68.Furthermore,Shanghai Score provided evaluation for adjuvant treatment choices (transcatheter arterial chemoembolization or interferon-α).The identified subset of patients at low risk could be ideal candidates for curative surgery,and subsets of patients at moderate or high risk could be recommended with possible adjuvant therapies after surgery.Finally,a web server with individualized outcome prediction and treatment recommendation was constructed.Conclusions:Based on the largest cohort up to date,we established Shanghai Score-an individualized outcome prediction system specifically designed for Chinese HCC patients after surgery.The Shanghai Score web server provides an easily accessible tool to stratify the prognosis of patients undergoing liver resection for HCC.

Objective To explore characteristics of co-infection of Chlamydia pneumoniae(Cpn)and severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),and identify their effect on SARS-CoV-2-induced inflammatory response.Methods Patients with coronavirus disease 2019(COVID-19)who received treatment in a hospital in Chenzhou City from December 20,2022 to February 20,2023 were selected.According to the severity of COVID-19,severe and critical cases were classified as the severe symptom group,while mild and moderate cases were classified as the mild symptom group.Meanwhile,according to the age of patients(≥18 years old as adults,＜18 years old as juveniles),they were divided into the adult severe symptom group,adult mild symptom group,juvenile severe symptom group,and juvenile mild symptom group.Propensity score was adopted to match age,gender,and under-lying diseases of patients in severe symptom and mild symptom group in a 1∶1 ratio.Bronchoalveolar lavage fluid(BALF),throat swabs,and serum specimens of patients were collected.Cpn IgG/IgM antibody was detected by enzyme-linked immunosorbent assay(ELISA),levels of 12 common cytokines(including interleukin-8[IL-8])in BALF were detected by flow cytometry,differences among groups were compared.Results A total of 102 patients were included,with 61 severe and critical(severe symptom)patients,as well as 41 mild and moderate(mild symp-tom)patients.There were 71 patients aged ≥18 years and 31 juvenile patients aged＜18 years.There were 39 pa-tients in the adult severe symptom group and 32 in the adult mild symptom group,and 30 pairs were successfully matched through propensity score analysis.There were 22 patients in the juvenile severe symptom group and 9 in the juvenile mild symptom group,and 8 pairs were successfully matched through propensity score analysis.Among COVID-19 patients,the positive rates of Cpn IgG and IgM were 36.27％(n=37)and 8.82％(n=9),respective-ly,with 1 case positive for both Cpn IgG and IgM.The level of interferon(IFN)-α in serum specimens from adult patients with severe symptom combined with positive Cpn IgG was higher than that of IgG negative patients(P=0.037).There was no statistically significant difference in the levels of other cytokines in BALF and serum speci-mens between the two groups of patients(all P＞0.05).The levels of IL-8 and IL-17 in serum specimens of patients with positive Cpn IgG in the adult mild symptom group were both higher than those in Cpn IgG negative patients(both P＜0.05).The levels of IL-8 in both BALF and serum specimens from Cpn IgM positivity patients in the ju-venile mild symptom group were higher than those from patients with negative Cpn IgM(both P＜0.05).Logistic regression analysis results showed that Cpn IgG and IgM positivity were not risk factors for the development of se-vere COVID-19.Conclusion Combined Cpn infection is not a risk factor for the development of severe symptom in COVID-19 patients,and Cpn infection has limited impact on the secretion of inflammatory factors caused by SARS-CoV-2.