Impact of the pulmonary ventilation function on the prognosis of suspected asthma patients: a retrospective observational study.

OBJECTIVE: Asthma is a common chronic respiratory diseases, and the relationship between pulmonary ventilation function and the prognosis of patients with suspected asthma is not well understood. This study aims to explore the impact of pulmonary ventilation functions on the prognosis of patients with suspected asthma. METHODS: This retrospective observational study included patients with suspected asthma who were diagnosed and treated at the Guangdong Provincial Hospital of Traditional Chinese Medicine between August 2015 and January 2020. The primary outcome of interest was improvement in asthma symptoms, as measured by bronchial provocation test (BPT) results within one year after diagnosis. The impact of pulmonary ventilation functions on prognosis was explored by multivariable logistic regression analysis. RESULTS: Seventy-two patients were included in the study. Patients with normal (OR = 0.123, p = .004) or generally normal (OR = 0.075, p = .039) pulmonary ventilation function were more likely to achieve improvement in asthma symptoms compared with patients with mild obstruction. There were no significant differences between the improvement and non-improvement groups in baseline characteristics. CONCLUSION: These results suggest that suspected asthma patients with normal or generally normal pulmonary ventilation function are more likely to achieve improvement in asthma symptoms within one year compared to patients with mild obstruction.

Static mechanical analysis of the vertebral body after modified anterior cervical discectomy and fusion (partial vertebral osteotomy): a finite element model.

BACKGROUND: Modified anterior cervical discectomy and fusion (Mod ACDF) can effectively address ossification of the posterior longitudinal ligament (OPLL), which is difficult to remove directly from the posterior edge of the vertebral body, with considerably lesser damage as compared to anterior cervical corpectomy and fusion (ACCF). We compared the static mechanics of different anterior approaches by using an ideal finite element model. METHODS: A complete finite element model was established and classified into the following three surgical models according to different model cutting operations: ACDF, ACCF, and Mod ACDF. Three different bone volume situations (normal bone mineral density, osteopenia, and osteoporosis) were simulated. After fixing the lower surface of C5 or C6, a load was applied to the upper surface of C4, and the stress distribution and displacement of the upper surface of C5 or C6 were observed and the related values were recorded. RESULTS: The average Von Mises Stress and displacement levels of Mod ACDF were between those of ACDF and ACCF; with the peak Von Mises Stress occurring on the posterior side of the vertebral body (Points 1-4). The change in Von Mises Stress of the vertebral body is not significant during bone loss. However, the degree of displacement of the vertebral body surface and risk of vertebral collapse are increased (100 N: 13.91 vs. 19.47 vs. 21.62 µm; 150 N: 19.60 vs. 29.30 vs. 31.64 µm; 200 N: 28.53 vs. 38.65 vs. 44.83 µm). CONCLUSIONS: The static biomechanical effects caused by Mod ACDF are intermediate between ACDF and ACCF, and the risk of vertebral body collapse is lower than that by ACCF. Therefore, Mod ACDF may be an effective solution when targeting OPLL with poorly positioned posterior vertebral body edges.