Objective To investigate the peripheral blood cytopenias in patients with portal hypertension complicated with splenomegaly. Methods The clinical data of 309 patients with portal hypertension who had been admitted to our department from January 1991 to December 2006 were retrospeetively analyzed. Results Of all patients, 278 showed peripheral blood cytopenia, ineluding 71 with paneytopenia, 48 with leukocyte and platelet decrease, 25 with erythroeyte and platelet decrease, 33 with leukocyte and erythroeyte decrease, 28 with platelet decrease, 26 with leukocyte decrease, and 47 with erythrocyte deerease. The number of blood cells increased significantly after splenectomy ( t=6.53, P<0.01). The whole blood cells of the remaining 31 patients without hematocytopenia were normal. Conclusions Patients with portal hypertension eomplieated with splenomegaly do not always accompany peripheral blood eytopenia. Peripheral blood cytopenia is one of the complications of splenomegaly, hut it dose not always appear. Splenectomy is effective in the treatment of hematocytopenia. The reason for some patients do not have peripheral blood cytopenia may be related to the slight pathological changes of spleen and severe hyperplasia of bone marrow.

Objective To explore the correlation between the total imaging burden of cerebral small vessel disease(CSVD)and heart rate variability(HRV)in elderly patients with hypertension.Methods A total of 256 elderly patients with hypertension admitted to Department of Neurolo-gy,Changzhou Second People's Hospital form September 2021 to December 2022 were consecu-tively recruited in this study.According to the total brain MRI burden,they were divided into scored 0-2 group(180 cases)and 3-4 group(76 cases).Their general clinical data and HRV parameters were compared between the two groups.Multivariate logistic regression analysis was used to analyze the relationship between HRV and total CSVD burden in these patients,and Spearman correlation analysis was employed used to analyze the correlation between HRV and to-tal CSVD burden,and between blood pressure variability and HRV.Results Older age,longer course of hypertension,and higher homocysteine level were observed in the group of scored 3-4 than the group of 0-2(P＜0.01).The former group had significantly lower SDNN,SDANN,ASDNN,rMSSD,PNN50,LF and HF when compared with the latter group(all P＜0.01).But there was no statistical difference in LF/HF ratio between the two groups(P＞0.01).Multivariate logistic regression analysis indicated that SDNN(OR=0.989,95％CI:0.979-0.999,P=0.034),SDANN(OR=0.988,95％CI:0.977-0.999,P=0.039)and rMSSD(OR=0.965,95％CI:0.938-0.994,P=0.016)were independent risk factors for total burden of severe CSVD in elderly hypertensive patients.Spearman correlation analysis showed that SDNN,SDANN,ASDNN,rMSSD,PNN50,LF and HF were negatively correlated with the total CSVD burden(P＜0.01);the standard deviation of 24-h SBP was negatively correlated with SDNN,SDANN and rMSSD(P＜0.01);the coefficient of variation of 24-h SBP was negatively correlated with SDNN,SDANN and rMSSD(P＜0.01).Conclusion HRV is an independent risk factor for total burden of severe CSVD in elderly hypertensive patients,and HRV parameters are negatively correlated with the to-tal CSVD burden.

OBJECTIVE: To analyze the accuracy of free-hand thoracic pedicle screw placement in severe idiopathic scoliosis via CT scan. METHODS: Twenty patients with complete CT data were chosen out of 58 patients of severe idiopathic scoliosis from June 1996 to December 2006. The Cobb angle of the main thoracic curve was from 82 degree to 142 degree (96.3 degree +/- 14.3 degree). The kyphotic angle in the main curve was 66.2 degree +/- 12.4 degree. The placement of thoracic pedicle screw was completed free-handedly, and the accuracy of screws placement was evaluated with CT thin-slice scan postoperatively. RESULTS: Altogether 174 thoracic pedicle screws were inserted, 157 (90.2%) of which were fully contained within the cortical boundaries of the pedicle.The other 17 screws (9.8%) were misplaced in 9 patients: 11 screws (6.8%) were lateral, 9 of which had a breach 0.05). There was no neural complication in all patients. CONCLUSION It is fairly accurate place thoracic pedicle screw in severe idiopathic scoliosis free-handedly, with some misplacements.
Adolescent ; Bone Screws ; Female ; Humans ; Male ; Orthopedic Procedures ; methods ; Scoliosis ; diagnostic imaging ; pathology ; surgery ; Thoracic Vertebrae ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult