4.Comparison of biomechanical effect between oblique Ban-pulling manipulation and lumbar erection-rotation manipulation in sitting position for lumbar intervertebral disc herniation
nong Xin SHU ; zhi Wen MU ; feng Jin CHEN ; jie Ying ZHANG ; jie Shu TANG
Journal of Acupuncture and Tuina Science 2017;15(5):317-321
Objective:To compare the biomechanical effects between oblique Ban-pulling manipulation and lumbar erection-rotation manipulation in sitting position in treating lumbar intervertebral disc herniation (LIDH). Methods:A three-dimensional finite element model of L3-S1 was developed to carry out a comparative study between oblique Ban-pulling manipulation and lumbar erection and rotation manipulation in sitting position. The disc protrusion was assumed to be on the rear left of L4 disc, and the manipulations were performed on the right side. The loading process was simulated by two steps. In the first step, only the compression loading was imposed, and in the second step, both the compression loading and axial rotation moment were imposed. The displacement and stress distribution in L4 disc were investigated. Results:The values of stress and displacement in the second step were lower than those in the first step in each manipulation. The stress and displacement differences between the two steps were respectively 1.79 times and 3.03 times larger in oblique Ban-pulling manipulation than those in lumbar erection-rotation manipulation in sitting position. Conclusion: Oblique Ban-pulling manipulation may result in a better biomechanical effect than lumbar erection-rotation manipulation in sitting position for LIDH.
5.Value of hysteroscopy and laparoscopy in differential diagnosis of gestational trophoblastic neoplasia
Feng-Zhi FENG ; Yang XIANG ; Hao-Jie HE ; Xi-Run WAN ; Xiu-Yu YANG ;
Chinese Journal of Obstetrics and Gynecology 2001;0(07):-
Objective To determine the efficacy of hysteroscopy and laparoscopy in differential diagnosis of pregnancy-related diseases,including gestational trophoblastic neoplasia(GTN),incomplete abortion and ectopic pregnancy.Methods Twenty-seven patients with a suspected diagnosis of GTN were transferred to Peking Union Medical College Hospital from September 2003 to March 2006,and underwent hysteroscopy and laparoseopy.Clinical data of patients were reviewed retrospectively.Most patients had abnormal vaginal bleeding and persistently elevated plasma beta human chorionic gonadotropin(?-hCG) level for a median(53?37)days(range,15-125 days)after evacuation.Ultrasound revealed a lesion with affluent blood flow in intrauterine,unilateral horn of uterus,or myometrium.No positive findings were revealed by computerized tomography or X-ray of the chest in all patients.Eleven patients underwent evacuation under hysteroscope,10 patients were diagnosed and treated by laparoscopy,and 6 by hysteruscopy and laparoseopy.Results Choriocarcinoma was diagnosed in 4 patients,who achieved complete remission by chemotherapy later.The diagnosis of GTN was ruled out in the other 23 patients, including cornual pregnancy in 12,pregnancy in rudimentary horn in 1,and incomplete abortion in 10,who were cured by hysteroscopic and laparoscopic surgery and postoperative adjuvant single dose methotrexate.Conclusions The major causes of pregnancy-related abnormal bleeding include incomplete abortion,eetopic pregnancy,and GTN.Hysteroscopy and laparoseopy are effective alternative of diagnosis for differentiation of GTN from non-GTN and can also offer therapeutic treatment.
6.A retrospective study of Schatzker III tibial plateau--fracture using minimally invasive fixation and bone grafting through medial side.
Zhi-dan LING ; Jian-feng WANG ; Hai-bo SONG ; Hao-jie GU
China Journal of Orthopaedics and Traumatology 2015;28(12):1114-1116
OBJECTIVETo investigate clinical effects of minimally invasive fixation and bone grafting througn medial side for the treatment of Schatzker III tibial plateau fracture.
METHODSFrom April 2009 to August 2011, 18 patients with Schatzker III tibial plateau fracture were treated with minimally invasive fixation and bone grafting through medial side. There were 15 males and 3 females ranging in age from 64 to 73 years, with an average of (69.75 ± 1.22) years. Sixteen patients were caused by falling down, 2 cases were caused by traffic accident. Operative time and length of incision were be recorded. Clinical and radiological follow-up was performed after operation. Hospital for Special Surgery (HSS) score and Kellgren-Lawrence score were used to evaluate clinical effects.
RESULTSThe mean operative time was (45.32 ± 1.58) min, and the mean length of incision was (5.21 ± 0.65) cm. Postoperative X-ray showed excellent reduction. Eighteen patients were followed up for 10 to 13 months with an average of (11.5 ± 1.35) months. The mean HSS score was 86.51 ± 2.71, 12 cases got excellent results,4 good and 2 fair. Three patients were developed mild osteoarthritis according to the Kellgren-Lawrence system.
CONCLUSIONMinimally invasive fixation and bone grafting through medial side, not only could reduce surgical invasive, but also guarantee early function activities. It has advantages of keeping well after reduction. So it has the favorable future in clinic.
Aged ; Bone Transplantation ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Retrospective Studies ; Tibial Fractures ; surgery
7.Placement of a Long Intestinal Tube in Patients with Early Postoperative Small Bowel Obstruction under Fluoroscopic Guidance.
Zhi-wei WANG ; Xiao-guang LI ; Jie PAN ; Ning YANG ; Hai-feng SHI ; Zheng-yu JIN
Chinese Medical Sciences Journal 2015;30(3):156-161
OBJECTIVETo investigate the placement of a long tube into the small intestine under fluoroscopic guidance and to evaluate its decompression effect on early postoperative small bowel obstruction (EPSBO).
METHODSFifty-four patients with EPSBO requiring decompression between April 2010 and July 2014 were enrolled in the study. Insertion of a long tube was guided by fluoroscopy. We first used the guide wire to pass the pylorus and then used the 10 Fr feeding tube as an exchangeable tube to put the superstiff wire into the duodenum. Finally the long tube could be passed over the guide wire through the pylorus into the intestine. The total procedure time, the radiation exposure time, and the incidence of complications were evaluated.
RESULTSThe long tubes passed into the jejunum on initial insertion for all patients, so the success rate of this technique was 100%. The long tube was inserted into ileum in 18 patients. The mean total procedure time was 34.4 ± 8.6 minutes, and the mean radiation exposure time 18.9 ± 6.8 minutes. A total of 47 patients (87%) experienced full recovery following long-tube decompression and without the need for surgical intervention.
CONCLUSIONSUsing the wire-exchange technique, it is easy to place a long tube into the small bowel under fluoroscopic guidance. This decompression method is safe and effective for management of EPSBO.
Adult ; Aged ; Decompression, Surgical ; methods ; Female ; Fluoroscopy ; Humans ; Intestinal Obstruction ; surgery ; Male ; Middle Aged ; Postoperative Complications ; surgery ; Retrospective Studies
8.Streptococcal toxic shock syndrome in a case.
Li-jie WANG ; Zhuang YUAN ; Chun-feng LIU ; Cui-zhi YAN ; Guang-xia ZHAO
Chinese Journal of Pediatrics 2003;41(12):939-939
9.The analysis of failure cause of valproate monotherapy for newly diagnosed generalizedepilepsy in children
Zhi JIANG ; Liming YANG ; Zeshu NING ; Bo CHEN ; Jie ZHANG ; Feng GUO
Chinese Journal of Nervous and Mental Diseases 2016;42(8):479-483
Objectives To investigate the failure cause of valproate monotherapy for newly diagnosed generalized epilepsy in children and to investigate the factors related to the failure. Methods The newly diagnosed cases of general?ized epilepsy were recruited and given valproate monotherpy. After 2 years of treatment and regular follow-up, they were divided into control group and poor effect group.according to their response to the treatment. The clinic data and electro?encephalogram were collected. The reasons of treatment failure were studied using Logistic regression analysis. Results There were 231 patients who had completed this study in all. After 2 years, 62 cases had switched to other drugs because of poor efficacy. Efficacy of was satisfactory in 169 cases of children. There were 3 cases of poor compliance, and one case switched to other drug due to side effect. There were statistically significant (P<0.05) in the abnormal electroenceph?alogram (EEG) rate (poor effects group 90.32%vs. control group 61.54%), abnormal cranial magnetic resonance imaging (MRI) rate (poor effects group 45.16%vs. control grou p23.08%) and the first age of onset [poor effects group 0.50(0.42, 2.50)year vs. control group 0.75(1.50, 5.16)year] between the good effects group and poor effects group. Univariate anal?ysis showed that mental retardation,birth asphyxia,abnormal bain MRI,the first episode of age were statistically signifi? cant different between these two groups (P<0.05). Further multivariate regression analysis showed that the low first onset age (OR=2.124 P=0.004)、mentalretardation (OR=10.535,P=0.000, abnormal brain MRI(OR=1.603,P=0.020), asphyxia at birth(OR=1.913 P=0.027)were independent risk factors for the poor efficacy of valproate. Conclusions The main rea?sons for the failure of valproate monotherpy in children with generalizedepilepsy are poor efficacy,bad compliance, ad?verse reactions. The risk factors of poor efficacy are the low first onset age, mental retardation, abnormal brain MRI and asphyxia at birth etc.
10.Clinical Features and Genetic Analysis of Pediatric Patients with Alagille Syndrome Presenting Initially with Liver Function Abnormalities
Yan LIU ; Hong WANG ; Chen DONG ; Jie-Xiong FENG ; Zhi-Hua HUANG
Journal of Huazhong University of Science and Technology (Medical Sciences) 2018;38(2):304-309
Alagille syndrome (AGS) is a multisystem disorder and caused by mutations in JAG1 or NOTCH2 gene.The diagnosis of AGS is hampered by its highly variable clinical manifestations.We performed a retrospective analysis on 16 children diagnosed as having AGS in recent five years in our hospital.Cholestasis was seen in 15 patients (93.8%),heart disease in 12 (75%),characteristic facies in 7 (43.8%),and butterfly vertebrae in 7 (43.8%).Ophthalmology examination was not performed on all the patients.Further,serum biochemical parameters were compared between AGS and 16 biliary atresia (BA) patients who were confirmed by surgery.Elevated liver enzymes were seen in all the patients.Serum total cholesterol (TC) (P=0.0007),alanine aminotransferase (ALT) (P=0.0056),aspartate aminotransferase (AST) (P=0.0114),gamma-glutamyl transferase (GGT) (P=0.035) and total bile acid (TBA) levels (P=0.042) were significantly elevated in AGS patients compared to those in BA cases.However,there were no significant differences in serum total bilirubin (TB),conjugated bilirubin (CB) and albumin (ALB) between the two groups.We identified 14 different JAG1 gene variations and 1 NOTCH2 gene mutation in 16 Chinese AGS patients.Our study suggested clinical features of AGS are highly variable and not all patients meet the classical diagnostic criteria.It was suggested that hypercholesterolaemia and significantly elevated GGT,TBA and ALT may be helpful to diagnose AGS.Genetic testing is integral in the diagnosis of AGS.