1.Analysis of clinical treatment of 162 cases of acute coronary syndrome
Chinese Journal of Primary Medicine and Pharmacy 2015;(15):2292-2295
Objective To analyze acute coronary syndrome patients with clinical characteristics and the sta-tus survey of the interventional treatment in the datong area.Methods 162 cases of hospitalized patients with unsta-ble angina pectoris(UA)and non ST segment elevation myocardial infarction(NSTEMI)were selected through clini-cal records,with UA78 cases and NSTEMI 84 cases.Results Clinical features:(1 )Two groups of high incidence were men,and incidence cases were 2 times than that in women.Peaks in males were 50 -60 years old,and lasted 20 years in UA group;Peaks delayed 10 years of women thanthat of men in UA group,delayed 20 years in NSTEMI group.Over the 70 -year -old,there were no gender,number differences in the two groups.Hypertension,hyperlipi-demia,diabetes,number of cases were quite in two groups.(2)The history of coronary heart disease (CHD)were respectively:in UA group,patients with 1 year or less were 48 (61.5%),30 cases (38.5%)>1 year.NSTEMI group had 67 cases (79.8%)in 1 year or less,>1 year with 7 cases (20.2%),(t =2.915,-2.743,all P <0.01).In the subgroups which the morbidity was 1 day or less,UA group had 5 cases (6.4%),NSTEMI group had 25 cases (29.8%)(t =4.066,P <0.01).(3)History of OMI respectively:UA group 18 cases (23.1%),the NSTE-MI group 8 cases (9.5%)(t =-2.533,P <0.05),the difference between the two groups had statistical signifi-cance.Coronary lesions:(1 )stents:During 78 cases of patients with UA,direct percutaneous coronary intervention (PCI)treatment were 71 cases (91.0%).During 84 NSTEMI patients,direct PCI were 63 cases (75.0%).(2)Sin-gle lesion:UA group of stents treatment were 18 cases (11.1%),the NSTEMI group were10 cases (6.2%),and had a statistically significant difference between the two groups (χ2 =26.309 P <0.01).The third.The incidence of heart for death in hospitalized patients:In the 162 cases of patients,hospital death was 3 patients (1.9%),and had occurred in NSTEMI group (3.6%),there was statistically significant difference between the two groups (χ2 =2.838 P1 -sided <0.05).Conclusion In front of coronary heart disease incidence peak,the high -risk groups:hyperten-sion,hyperlipidemia,diabetes,to carry on the curative effect of standard treatment for a long time,it is the key to avoid the risk of coronary heart disease (CHD).NSTEMI cardiac mortality,need hospital treatment.Not only secondary pre-vention of coronary artery disease focus groups of HP,hyperlipidemia,DMand also cannot ignore OMI crowd.because myocardial ischemia often,even NSTEMI.Correct myocardial ischemia is the key of the coronary heart disease treat-ment,if the drug is invalid,stents treatment should be taken into account.
2. Progress in the application of posterior cervical lateral mass screw fixation
Shitong FENG ; Qi FEI ; Yong YANG
International Journal of Surgery 2019;46(11):763-767
Posterior cervical lateral mass screw fixation refers to the surgical procedure for treating cervical vertebrae disease by inserting a needle into the lateral side of the cervical vertebra and achieving internal fixation to the cervical vertebrae by screws, connecting plates and the like. In view of the high degree of cervical vertebra activity and complex structure, adjacent to the cervical spinal cord and multiple nerves and blood vessels, the cervical spine is difficult to place and has a certain degree of risk, and the posterior cervical lateral mass screw fixation can effectively reduce the incidence of injuring the nerves and vessels. In recent years, the clinical research on the posterior approach of the cervical spine is more and more abundant. In order to facilitate the clinician to better understand the advantages and disadvantages of the procedure and the development direction of the new technology of dynamic tracking. Now, a review of the application of this technique in recent years is reviewed.
3.A novel nomogram for predicting postoperative stiffness after arthroscopic rotator cuff repair
Bo YUAN ; Shaolong ZHANG ; Dong MA ; Ming TIAN ; Shitong FENG ; Junjie ZENG
Chinese Journal of Orthopaedics 2024;44(20):1321-1330
Objective:To investigate the risk factors for postoperative stiffness following rotator cuff repair and to develop a predictive risk assessment model.Methods:A retrospective analysis was conducted on 251 patients (111 males and 140 females) who underwent rotator cuff repair at the Department of Orthopedics, Civil Aviation General Hospital, from June 2016 to December 2022. Patients were divided into two groups based on the time of admission: the modeling group, comprising patients treated from June 2016 to June 2021, was used to construct the risk assessment model, while the validation group, including those treated from July 2021 to December 2022, was used to evaluate the model's effectiveness. In the modeling group, the incidence of postoperative stiffness one year after surgery was assessed. The study collected data on age, sex, body mass index, disease duration, smoking history, diabetes history, preoperative fat infiltration of the rotator cuff muscles, tear size, suturing technique, preoperative stiffness, re-tear rate, visual analogue scale (VAS) scores at two and six weeks postoperatively, Constant-Murley scores at six weeks postoperatively, and both preoperative and postoperative critical shoulder angle (CSA), acromial index (AI), and lateral acromion angle (LAA). Univariate analysis was used to identify potential risk factors for postoperative stiffness, followed by multivariate logistic regression to construct the risk assessment model. The validation group was used to reassess the identified risk factors.Results:Postoperative stiffness occurred in 21 out of 176 patients in the modeling group. Logistic regression analysis revealed that diabetes history, higher fat infiltration of the rotator cuff muscles, larger tear size, preoperative stiffness, higher VAS score at six weeks postoperatively, and lower Constant-Murley score at six weeks postoperatively were significant risk factors for postoperative stiffness. Based on the logistic regression model, a nomogram was created using R software. In the validation group, postoperative stiffness was observed in 11 out of 75 patients. The area under the ROC curve (AUC=0.926) indicated good discriminative ability in predicting postoperative stiffness. The goodness-of-fit test (H-L test: χ 2=2.215, P=0.947) demonstrated moderate calibration of the model. Conclusion:A history of diabetes, high fat infiltration of the rotator cuff muscles, large or massive rotator cuff tears, preoperative stiffness, higher VAS scores at six weeks postoperatively, and lower Constant-Murley scores at six weeks postoperatively are significant risk factors for postoperative stiffness after rotator cuff repair. The risk assessment model shows good discriminative power and calibration, making it a useful tool for predicting the risk of postoperative stiffness following rotator cuff repair.