الملخص
Objective:To evaluate the safety and effectiveness of distal femoral osteotomy combined with arthroscopy in the treatment of valgus knee.Methods:A retrospective analysis was conducted on 24 patients (25 knees) with valgus knee osteoarthritis admitted to the First Hospital of Jiaxing from January 2017 to December 2020 who underwent distal femoral osteotomy combined with arthroscopic surgery and were fixed with domestically produced distal femoral locking plates. The changes in hip knee ankle angle (HKA), distal lateral femoral angle (LDFA), knee joint range of motion (ROM), and knee joint function score (HSS) of the American Special Surgery Hospital before and after surgery were statistically analyzed.Resultsl:A total of 24 patients (25 knees) were followed up for (15.6±2.3)months. HKA increased from (171.22±2.51)° before surgery to (179.24±1.86)° at the last follow-up; LDFA increased from (82.17±2.03)° before surgery to (88.57±1.53)° at the last follow-up; The differences were statistically significant ( P<0.05). The HSS score improved from preoperative (60.27±6.04) to the last follow-up (87.80±5.50), with a statistically significant difference (all P<0.05). One out of 25 knees experienced loss of osteotomy angle, without insufficient or excessive correction, infection, and non union of fractures. Conclusions:The use of distal femoral osteotomy combined with arthroscopic surgery for the treatment of valgus knee osteoarthritis is a safe and reliable method. Retaining the lateral bone hinge during osteotomy is an important factor in maintaining the osteotomy angle and fracture healing.
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[Objective]To study the academic characteristics of the diagnosis and treatment of measles in FENG's Secret Book of Medicine,so as to provide schemes for the diagnosis and treatment of measles.[Methods]Taking the section of measles in FENG's Secret Book of Medicine as the main object of the study,the article systematically studied the characteristics of FENG's diagnosis and treatment of measles by combining the relevant contents in Inner Canon of Huangdi,Yi Guan and some other writings.[Results]FENG Zhaozhang was one of the physicians who systematically studied measles earliest in the history of Chinese medicine.In terms of diagnosis,he judged the severity of the disease by color,shape,location of the erythra and general condition of the patient,and differentiated measles from febrile diseases,smallpox and other diseases.In terms of treatment,he agreed with the predecessors on treating measles by cooling and diffusing,and he specialized in dissipating excessive stagnation of fire and eliminating fire by diaphoresis and purgation respectively.However,he clearly pointed out that the pathogenesis of measles was not only fire in lung and stomach,but also deficiency in spleen,stomach and Mingmen,and treating deficiency syndromes should always be based on strengthening the vitality,which had corrected the abuse of cooling and diffusing medicine in the treatment of measles through the ages.In addition,FENG's experience of nursing and treating pregnancy combined with measles was also of significance.[Conclusion]FENG Zhaozhang was well-experienced in the diagnosis and treatment of measles,and established complete theories,methods and prescriptions,which provided theories and methods for the diagnosis and treatment of measles,and was of significant value.
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Objective:To compare the clinical efficacy of unilateral biportal endoscopy (UBE) and uniportal endoscopy (UE) for unilateral laminotomy for bilateral decompression (ULBD) in the treatment of lumbar spinal stenosis.Methods:Data of 82 patients with lumbar spinal stenosis treated by ULBD under UBE or UE from January 2020 to June 2021 in Dalian Central Hospital affiliated to Dalian Medical University and the First Hospital affiliated to Wenzhou Medical University were retrospectively analyzed, including 36 males and 46 females, aged 63.3±7.5 years (range, 47-81 years). According to the surgical procedure, they were divided into UBE group (42 cases), including 20 males and 22 females; aged 63.2±7.6 years (range, 47-81 years) and UE group (40 cases), including 16 males and 24 females; aged 63.5±7.5 years (range, 48-80 years). Operation time, hospital stay and surgical complications were compared between the two groups. Visual analogue scale (VAS) of low back and leg pain before surgery, 1 day, 7 d, 1 month and 6 months after surgery, and Oswestry disability index (ODI) before surgery, 1 month and 6 months after surgery were compared. Dural sac area before and after surgery, resection angle of ipsilateral facet joint, decompression rate of disc space and bone lateral recess were calculated.Results:All patients were operated successfully. In the UBE group, the operation time was 63.1±7.0 min, and the hospital stay was 3.9±0.9 d. The UE group was 61.2±6.2 min and 3.7±0.9 d, respectively ( t=1.31, P=0.195; t=1.24, P=0.217). The VAS of back and legs pain in UBE group decreased from 7.19±0.97 before operation to 3.43±0.63 points at postoperative 1 day, 1.71±0.60 at postoperative 7 d, 1.33±0.48 at postoperative 1 month and 1.36±0.48 points at postoperative 6 months ( F=352.29, P<0.001). The VAS score of the UE group decreased from 6.85±0.89 points before operation to 2.45±0.75 points at postoperative 1 day, 1.75±0.59 points at postoperative 7 d, 1.33±0.47 points at postoperative 1 month and 1.28±0.45 points at postoperative 6 months ( F=291.44, P<0.001). The VAS of low back and leg pain was higher in the UBE group than in the UE group at 1 day postoperatively ( t=6.41, P<0.001), and the difference was not statistically significant at 7 d postoperatively ( t=-0.27, P=0.786). The ODI of UBE group decreased from 66.62%±4.98% before operation to 21.81%±2.61% at postoperative 1 month and 11.62%±2.31% at postoperative 6 months ( F=1991.35, P<0.001). The ODI score of UE group decreased from 64.35%±5.16% before operation to 22.85%±3.26% at postoperative 1 month and 11.15%±2.86% at postoperative 6 months ( F=1931.18, P<0.001). The postoperative dural sac area of the UBE and UE groups was 135.1±10.0 mm 2 and 120.9±10.4 mm 2 ( t=6.30, P<0.001). The resection angle of ipsilateral facet joint was 69.3°±4.9° and 94.3°±4.1° in the two groups, respectively, with a statistically significant difference ( t=-25.00, P<0.001). The decompression rate of ipsilateral disk-flavum space was 39.0%±3.0% and 38.7%±3.3% in the two groups ( t=1.52, P=0.314). On the contralateral side was 41.6%±3.3% and 22.8%±3.2% ( t=26.32, P<0.001), respectively. The ipsilateral osseous side fossa decompression rate in the two groups were 70.0%±4.8% and 59.3%±3.9% ( t=15.64, P<0.001), the contralateral were 73.0%±3.4% and 48.4%±4.3% ( t=28.86, P<0.001). There was no significant difference in the decompression rate of ipsilateral disco-flavum space or bony lateral recess between the UBE group and the contralateral group ( t=-1.40, P=0.174; t=-1.72, P=0.096), while the decompression rate of discoflavum space and bony side recess on the ipsilateral side of UE group were higher than those on the contralateral side ( t=28.51, P<0.001; t=13.95, P<0.001). Conclusion:Both UE-ULBD and UBE-ULBD have good short-term clinical efficacy in patients with lumbar spinal stenosis. UB is better than UBE in early postoperative pain relief. However, UBE shows better imaging performance in decompression effect and better retention of facet joints.
الملخص
Through literature search and screening, with qualitative research methods and the guidance of the three-level coding framework of grounded theory, literature about interview and factual records with Kampo medicine as theme was analyzed to explore concern areas and key points of Kampo medicine. The included literature mainly showed the modern development prospect of Kampo medicine from the fields of the revival background, laws and regulations, clinical work, education and teaching, scientific research, Kampo medicine industry, periodicals and books, representatives, symbolic events, organization and communication of Kampo medicine. Among them, half or more of the literature involved specific aspects such as clinical diagnosis and treatment methods of Kampo medicine, international communication, drug dosage forms and marketing, scientific research institutions and clinical research, and university education. At the same time, the specific aspects of events, legislation, organizations, periodicals, books and representatives mentioned in the literature provided important indexes for the comparative study of traditional medicine between China and Japan. In the future, the above fields and aspects can be set as starting points and main framework to further obtain and research relevant interviews and documentary literature, so as to promote the communication and development of traditional medicine at home and abroad.
الملخص
Cervical spondylotic radiculopathy is one of the commonly seen spinal surgery diseases. For well-diagnosed and well-located cervical spondylotic radiculopathy, surgical intervention can effectively alleviate symptoms. With the wide application of minimally invasive surgical techniques, the requirements for precise preoperative orientation of responsible segments have increased, especially in multisegmental cervical spondylotic radiculopathy cases. However, due to the cutaneous pain distribution is often atypical, magnetic resonance imaging and neurological examinations may be not reliable enough for accurate location preoperatively which may fail to get a satisfactory surgical outcome. Selective nerve root block (SNRB) in preoperative localization of responsible nerve roots in cervical spondylotic radiculopathy has gradually increased. Yet this technology has been mostly used by anesthesiologists or radiologists, this field in minimally invasive spinal surgery is relatively blank. As we know, there is no previous review summarized the commonly used approaches of SNRB, the risk factors relating to complications, and the local precise blood vessels anatomy. In summary, we believe that combination these series of points with the necessity of preoperative precise location in cervical spondylotic radiculopathy may increase the safety of cervical SNRB. The keywords about "cervical" and "selective nerve root block" have been used in English and Chinese literature databases. The articles were filtrated by title, abstract and full text. There were 21 articles taken in the review. We summarized the history and distinction of different approaches including anterior lateral approach, lateral approach, posterior lateral approach, dorsal "direct" approach and dorsal 'indirect' approach, and described the indication of each approach. As well as the factors associating with catastrophic complications in cervical SNRB, for instance, the vascular distribution relating to vascular mistaken injection, steroid kind selection because large steroid particle may block some thin but vital arteries. In addition to cervical local blood vessels distribution and variation, the needle trajectory also played a key role in the complications of SNRB. Besides, other controversy points, such as whether use contrast media or not, the importance of the lateral position of the cervical spine, etc., were discussed in this review based on clinical researches. The purpose of the present study is hoping to provide some references for spine surgeons to apply SNRB technology more safely.
الملخص
Cervical spondylotic radiculopathy is one of the commonly seen spinal surgery diseases. For well?diagnosed and well?located cervical spondylotic radiculopathy, surgical intervention can effectively alleviate symptoms. With the wide appli?cation of minimally invasive surgical techniques, the requirements for precise preoperative orientation of responsible segments have increased, especially in multisegmental cervical spondylotic radiculopathy cases. However, due to the cutaneous pain distri?bution is often atypical, magnetic resonance imaging and neurological examinations may be not reliable enough for accurate loca?tion preoperatively which may fail to get a satisfactory surgical outcome. Selective nerve root block (SNRB) in preoperative localiza?tion of responsible nerve roots in cervical spondylotic radiculopathy has gradually increased. Yet this technology has been mostly used by anesthesiologists or radiologists, this field in minimally invasive spinal surgery is relatively blank. As we know, there is no previous review summarized the commonly used approaches of SNRB, the risk factors relating to complications, and the local pre?cise blood vessels anatomy. In summary, we believe that combination these series of points with the necessity of preoperative pre?cise location in cervical spondylotic radiculopathy may increase the safety of cervical SNRB. The keywords about "cervical" and"selective nerve root block" have been used in English and Chinese literature databases. The articles were filtrated by title, ab?stract and full text. There were 21 articles taken in the review. We summarized the history and distinction of different approaches including anterior lateral approach, lateral approach, posterior lateral approach, dorsal "direct" approach and dorsal'indirect'ap?proach, and described the indication of each approach. As well as the factors associating with catastrophic complications in cervi?cal SNRB, for instance, the vascular distribution relating to vascular mistaken injection, steroid kind selection because large ste?roid particle may block some thin but vital arteries. In addition to cervical local blood vessels distribution and variation, the needle trajectory also played a key role in the complications of SNRB. Besides, other controversy points, such as whether use contrast me?dia or not, the importance of the lateral position of the cervical spine, etc., were discussed in this review based on clinical research?es. The purpose of the present study is hoping to provide some references for spine surgeons to apply SNRB technology more safely.
الملخص
[Objective] To search Zhang Taiyan’s prentice of medicine,study his effect of academic thought and academic method. [Method] Complete collection of periodicals in the Republic of China, with the research methods of philology, based on the academic history.[Result]Many famous disciples of Zhang Taiyan are from Jiangsu and Zhejiang,such as Lu Yuanlei,Xu Hengzhi,Zhang Cigong,Chen Cunren,Zhang Polang,Yu Yunxiu,Sun Shiyang. They inherited Zhang Taiyan’s effect of academic thought and academic method,such as widely collecting prescriptions and verifying,canoniz Changsha school,referring Chinese medicine in Japan,paying attention to the textual research.[Conclusion]Zhang Taiyan’s prentice of medicine made outstanding contributions to Chinese medicine. To search Zhang Taiyan and his prentice of medicine is helpful to study the medicine history of Wu and Yue area.
الملخص
Objective To study the main risk factors related to the incidence of tuberculosis in China and to provide di -rections and basis for the protection of tuberculosis .Methods The results of 25 studies on the main risk factors of tubercu-losis of Chinese people from 2000 to 2012 were analyzed by meta-analysis method .Results The pooled odds radio values and 95%CI of history of exposure to pulmonary tuberculosis , smoking, marriage, contact with people, Bacille Calmette-Guerin (BCG)vaccination scar, BCG vaccination, low body mass index(BMI) , family history of tuberculosis, exposure to dust and to chemical fumes under working conditions were as follows:3.14(2.74-3.59),1.23(1.14 -1.33),3.05 (2.10-4.45),2.08(1.76-2.26),0.39(0.32 -0.47),0.58(0.46 -0.73),2.95(2.40 -3.64),2.56(1.82 -3.59),2.58(2.04-3.26),and 4.81(1.99-11.60).Conclusion Then History of exposure to pulmonary tuberculosis , smoking, marriage, contact with people , low BMI, family history of tuberculosis , exposure to dust and to chemical fumes under working conditions are considered to be the risk factors of pulmonary tuberculosis .While BCG vaccination scar and BCG vaccination are considered to be the protective factors of pulmonary tuberculosis .
الملخص
Objective For selecting and developing the excellent Bupleurum chinense to mass-produce seedlings and seeds in high quality.Methods B.chinense was picked from eight different areas,such as Lingchuan and Wanrong county in Shanxi Province,Longxi county in Gansu Province,and Shangluo in Shaanxi Province,etc.Rapid propagation was done.The testa of Zhongchai No.1 was scrapped or seeds were soaked in different phytohormones.The effects on germination rates of seeds were compared.ResultsThe optimum medium for bud propagation was B5supplemented with 1.0 mg/L 6-BA and 0.2 mg/L KT.The optimum medium for root induction of test-tube plantlets was 1/2 MS added with 0.1 mg/L NAA,0.5 mg/L IBA,and 1.0 mg/L DSC.The annual propagation coefficient of B.chinense plants was more than 1?108,and the survival rate of transplantation reached to 94%—97%.The phytohormone has little effect on seed germination of B.chinense,but scraping the testa could increase the germination percentage of seeds to 20% and shorten the germinating time greatly.Conclusion By tissue culture of excellent B.chinense,a great deal of plants and seeds could be produced in short time.By scrapping testa in a certain extent,the germination of seeds could be increased.
الملخص
Objective To study the condition for induction and differentiation of callus and propagation of adventitious buds in lamina,stem,and bud of Bupleurum chinese and establish a new method for rapid propagation.Methods In MS media added with different phytohormones,calli were induced from explants of lamina,stem,and floral bud of B.chinese,adventitious buds and adventitious roots were differentiated from calli of stem and floral bud,test-tube plantlets were formed.Results MS Medium added with 2,4-D 1.0 mg/L,KT 0.5 mg/L,and 6-BA 0.5 mg/L was suitable for calli induction of the lamina,stems,and floral buds.In medium added with 6-BA 1.0 mg/L,NAA 0.03 mg/L,CM 15% and CH 500 mg/L,the differentiation rate of floral buds callus was the highest.MS Medium added with 6-BA 1.5 mg/L,NAA 0.05 mg/L and CH 250 mg/L was suitable for propagation of test-tube plantlets,1/2 MS medium added with NAA 0.5 mg/L was suitable for rooting.Conclusion A great deal of test-tube plantlets could be differentiated and propagated rapidly by calli induced from stems and floral buds of B.chinese.Then the regeneration plantlets with normal growth and development are obtained.