1.Effect analysis of posterior internal fixation and fusion on patients with spinal fractures
Clinical Medicine of China 2017;33(9):843-846
Objective To analyze the curative effect of posterior internal fixation and fusion on patients with spinal fractures, and to provide the basis for clinical application. Methods A total of one hundred and eighty?eight patients with orthopedic incision treated in the First Affiliated Hospital of Xinxiang Medical University from March 2013 to December 2016 were divided into the observation group ( 98 cases with posterior internal fixation fusion ) and the control group ( 90 cases with anterior internal fixation fusion ) . The clinical curative effects of the patients ( including Cobb angle,spinal nerve function,complications and the success rate of surgery ) , postoperative visual analogue score ( VAS ) , hospitalization time, operation time were compared. Results In the observation group,the VAS score before operation was (6. 89±6. 89) points and reduced to (2. 70±1. 33) points after operation,the pain decreased significantly after treatment (t=26. 099,P<0. 001). The VAS score of the control group lowered from (6. 85±6. 85) points to (5. 05±1. 35) points,and the pain decreased significantly after treatment ( t=10. 704, P<0. 001 ) , and the postoperative pain in the observation group was significantly reduced than that in the control group ( t=12. 016,P<0. 001) . There were significant differences between the observation group and the control group in operation time,intraoperative blood loss,incision length and hospitalization time ( ( 141. 91 ± 35. 42 ) min vs. ( 198. 82 ± 38. 61 ) min, ( 509. 72 ±113. 65) ml vs. (823. 40±108. 54) ml,(10. 25 ± 0. 84) cm vs. (18. 83±1. 58) cm,(10. 59±12) d vs. (15. 37±1. 52) d,t=10. 541,19. 315,47. 015,24. 681,P<0. 001) . The total effective rate of the observation group was 86 cases ( 97. 96%) , and ineffective rate of the observation group was 2 cases ( 2. 04%) . In the control group, the effective and ineffective rates were 75 cases ( 83. 33%) and 15 cases ( 16. 67%) , the difference in effective rate between the two groups was statistically significant (χ2 = 12. 202, P<0. 001 ) . Conclusion Posterior internal fixation fusion is effective in the treatment of spinal fracture,which can reduce the postoperative pain,shorten the hospitalization time,less complication and high success rate. It is suitable for clinical promotion.
2.Efficacy of low-energy laser in the treatment of erosive oral lichen planus in 43 patients
Mei WANG ; Yuhu MAO ; Haiying ZHENG
Chinese Journal of Primary Medicine and Pharmacy 2022;29(7):975-979
Objective:To investigate the clinical efficacy of low-energy laser in the treatment of erosive oral lichen planus (OLP) and its effect on patients' pain.Methods:Eighty-six patients with erosive OLP who were treated in Shanxian Central Hospital from February 2018 to January 2020 were included in this study. They were randomly divided into control and observation groups ( n = 43/group). The control group was treated by local injection of dexamethasone, and the observation group was treated with semiconductor low-energy laser irradiation. All patients were treated for 8 weeks. Pain scores and physical sign score before and after treatment were evaluated in each group. Therapeutic effects were compared between the two groups. Area of lesion was measured in each group. Recurrence of erosive OLP was calculated at 3 and 6 months after surgery. Results:Before treatment, there were no significant differences in visual analogue scale (VAS) score and physical sign score between the two groups (both P > 0.05). At 7, 14, 28 and 56 days after treatment, VAS score and physical sign score were significantly decreased in each group compared with those before treatment, and VAS score and physical sign score in the observation group were significantly lower than those in the control group (all P < 0.05). Total response rate in the observation group was significantly higher than that in the control group [93.02% (40/43) vs. 83.72% (36/43), χ2 = 1.81, P > 0.05). Before and 1 month after treatment, there was no significant difference in area of lesion between control and observation groups (both P > 0.05). At 3 and 6 months after surgery, area of lesion in the observation group was (0.31 ± 0.14) cm 2 and (0.32 ± 0.12) cm 2, respectively, which were significantly smaller than those in the control group [(0.42 ± 0.18) cm 2, (0.48 ± 0.19) cm 2, t = 3.16, 4.67, both P < 0.05). At 3 and 6 months after treatment, recurrence of erosive OLP in the observation group was 2.33% (1/43) and 13.95% (6/43), respectively, which were significantly lower than those in the control group [13.95% (6/43), 37.21% (16/43), χ2 = 3.89, 6.11, both P < 0.05]. Conclusion:There is no significant difference in the short-term efficacy of low-energy laser versus conventional corticosteroids in the treatment of erosive OLP. However, low-energy laser has a more obvious short-term pain relief effect than conventional corticosteroids. It can accelerate the healing of injured tissue and decrease the recurrence rate of erosive OLP.
3.Application of "upgraded single-entry colonoscope training method" in the primary endoscopic training of refresher doctors
Yuhu QU ; Congcong MIN ; Tao MAO ; Hua LIU ; Xiaoyan YIN ; Xiaoyu LI
Chinese Journal of Medical Education Research 2022;21(9):1240-1243
Objective:To explore the application of "upgraded single-entry colonoscope training method" in the primary endoscopic training of refresher doctors.Methods:A total of 71 refresher doctors who participated in the primary single endoscopy training in the Endoscopy Center of the Affiliated Hospital of Qingdao University from January 2017 to December 2019 were randomized to two groups: upgraded single-entry endoscopy training group ( n=36) and traditional single-entry endoscopy training group ( n=35). In the first week of training, all the participants learned the basic theory of single-entry enteroscopy insertion. From week 2 to week 11, each doctors of the two groups finally completed 80 to 100 cases of single-entry endoscopy. The upgraded single-entry colonoscopy training group was divided into two stages: "rectum-proximal sigmoid colon" and "descending colon-ileocecal part" with the boundary of descending-sigmoid colon as the dividing point, which was different from the traditional group. At the 12th week, each doctors were assessed by 20 cases of single-entry colonoscopy operation. the success rate of ileocecum insertion, the time to pass through sigmoid colon, the rate of loop formation and the average operation time of successful ileocecum insertion were compared between the two groups. SPSS 26.0 was used for t test or chi-square test. Results:Compared with the traditional single-entry endoscopy training group, the upgraded single-entry endoscopy training group achieved better results in the successful rate of ileocecal insertion (66.8% vs. 59.0%, P=0.005), the time to pass sigmoid colon [(6.05±3.32) min vs. (7.15±3.12) min, P<0.001], the loop rate (35.13% vs. 40.71%, P=0.035), the average operation time of successfully inserting the ileocecal part [(9.01±2.12) min vs. (10.25±3.12) min, P<0.001] and the discomfort response score [(5.19±1.41) vs. (6.70±2.15), P<0.001], with statistical significance between the groups. Conclusion:"Upgraded single-entry endoscopy training method" emphasizes no loop through sigmoid colon, which is more helpful for refresher doctors to master the operation skills of single-entry colonoscopy, shorten the teaching time, and reduce the discomfort of patients, and is suitable for popularization in the teaching.