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Objective:To explore the effect of conducting core stability training (CST) on an unstable supporting surface using thoracolumbar fracture patients with an incomplete spinal cord injury.Methods:Forty thoracolumbar fracture patients with incomplete spinal cord injury were randomly divided into an experiment group and a control group, each of twenty. Both groups received 30 minutes of CST five times per week for 8 weeks. The patients in the control group were trained on a stable supporting surface while those in the experiment group used an unstable surface. Evaluations were conducted before and after the 8-week intervention. Gait and static balance data were collected and analyzed using 3D motion analysis software and an EAB-100 active balancer.Results:After the intervention, the average stride length and comfortable walking speed of the experimental group were both significantly better than the control group′s averages. Moreover, the path length, circumferential area, rectangular area and effective value area of the Romberg rate were all significantly better, on average, in the experiment group, as was the average displacement of the deflection center with the eyes closed in static balance.Conclusions:An unstable supporting surface is superior to a stable one for conducting CST after thoracolumbar fracture with incomplete spinal cord injury. The effect may be due to improved nonvisual postural control.
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@#Objective To observe the effect of sling exercise therapy (SET) on rehabilitation after knee arthroplasty. Methods 46 patients after knee arthroplasty were randomly divided into experimental group (n=23) and control group (n=23). The control group received continuous passive motion (CPM) training, while the experimental group received SET. They were evaluated with range of motion (ROM) of the knee, Hospital for Special Surgery Knee Score (HSS) and posture control ability before, 15 days and 3 months after operation. Results 15 days after operation, the maximal passive knee flexion was 6.0° more in the SET group than in the CMP group (95%CI=0.9°~11.2°; P<0.01), and the maximal active knee flexion was 5.7° more in the SET group than in the CMP group (95%CI=0.4°~9.1°; P<0.01); however, there was no significant difference in the maximal active knee extension, the maximal passive knee extension, HSS and posture control ability between 2 groups (P>0.05). 3 months after operation, there was no significant difference in all the items between 2 groups (P>0.05). Conclusion Compared with CPM, SET might be more effective on increasing knee ROM in the short-term, and could be used as an effective intervention for patients after knee arthroplasty at the early stage.
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Objective To observe the effect of sling exercise therapy (SET) on rehabilitation after knee arthroplasty. Methods 46 pa-tients after knee arthroplasty were randomly divided into experimental group (n=23) and control group (n=23). The control group received continuous passive motion (CPM) training, while the experimental group received SET. They were evaluated with range of motion (ROM) of the knee, Hospital for Special Surgery Knee Score (HSS) and posture control ability before, 15 days and 3 months after operation. Re-sults 15 days after operation, the maximal passive knee flexion was 6.0° more in the SET group than in the CMP group (95%CI=0.9°~11.2°;P0.05). 3 months after operation, there was no significant difference in all the items between 2 groups (P>0.05). Conclusion Compared with CPM, SET might be more effective on increasing knee ROM in the short-term, and could be used as an effec-tive intervention for patients after knee arthroplasty at the early stage.
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Objective To summarize the experiences in the diagnosis and treatment of delayed rupture of spleen.Methods The clinical data of 26 patients with traumatic delayed rupture of spleen who were admitted to the Dachang Hospital from January 2005 to December 2013 were analyzed retrospectively.The medical history,clinical presentation,results of laboratory examinations were analyzed,and the splenic trauma was graded.Surgical procedures were selected according to the condition,severity of the splenic trauma and time of injury.Patients were followed up via outpatient examination or telephone interview till June 2014.Results Twenty-six patients had the history of injury of the left hypochodriac region,and were accompanied by slight abdominal pain and a short period of pain alleviation,and then pain in all regions of the abdomen at postoperative hour 48.All thepatients had pale face,tenderness,rebound tenderness or tonus.The pulse above 100 per minute was observed in 20 patients,and 15 patients had blood pressure under 90/60 mmHg (1 mmHg =0.133 kPa).The level of hemoglobin under 5 g/L was observed in 3 patients,and 5-10 g/L in 21 patients.All the 26 patients received abdominal paracantesis,non-coagulating blood was extracted in 25 patients.Twenty-six patients received B ultrasonography,and 24 had splenic rupture.Nineteen patients received computed tomography (CT),and 19 had splenic rupture.Ten patients had type Ⅰ splenic rupture,12 had type Ⅱ splenic rupture,3 had type Ⅲ splenic rupture and 1 had type Ⅳ splenic rupture.All the 26 patients received operation,including 2 received suture of the ruptured spleen,2 received resection of the lower part of the spleen,9 received total splenic resection,and 13 received total splenic resection + autogeneous transplantation of greater omentum.Two patients died of hemorrhagic shock intraoperatively,and the other 24 patients were cured.The operation time and volume of hemoperitoneum were (90 ± 15)minutes and (1 500 ± 700) mL,respectively.Twenty-four patients received blood transfusion,with the volume of transfused blood of 1 200 mL.The mean duration of hospital stay was 16.7 days.Two patients had complications after the operation,which were left pleural effusion and splenic fossa effusion,and they were cured by symptomatic treatment.No infection or other complications were observed.All the 24 patients were followed up for 6-108 months (median,46 months).One patient died of myocardial infarction at postoperative year 5,and the other 23 patients survived.Conclusions B sonography and computed tomography are important methods for the treatment of delayed rupture of spleen.Traumatic delayed rupture of spleen should be considered when the patient had symptoms including history of injury of the left hypochondriac region,the course of abdominal pain,abdominal pain alleviation,abdominal pain recurrence,time for abdominal pain alleviation longer than 48 hours,interperitoneal hemorrhage and the signs of splenic rupture indicated by B ultrasonography and computed tomography.The indication of spleen-preservation surgery or splenectomy for patients with delayed rupture of spleen should be strictly controlled and optimal surgical procedure should be designed according to the condition of the patient.
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Objective To explore the clinical characteristics,misdiagnosis reason,diagnosis and treatment of primany small intestinal tumor.Methoed Retrospective analysis of the clinical data were made on 40 cases of primary small intestinal tumors.Results Before operation,13 cases were given confirmed diagnosis of small intestinal tumor.The rate of misdiagnosis was 67.5％ (27/40).Partial excision were administered in 10 cases with benign small intestinal tumor.Adical excaision were performed in 24 cases with malignant tumors,palliative excision in 3 cases and shortcut operation in 3 cases.One patient died after opreation.Conclusions Before operation,the misdiagnostic rate of primary small intestinal tumor is high.Fiber endoscopy and X-ray may bring a high diagnostic rate of small intestinal tumor.
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[Objective]To establish an in vitro two-dimensional culture model of degenerated nucleus pulposus and detect samples' cell cycle by flow cytometry to study why nucleus pulposus cells don't grow well after passage. [Method]Nucleus pulposus tissues taken from protruded discs of 24 patients were treated by Trypsin and collagenase after surgical procedures,and then the cells were cultured in DMEM/F12 medium.Cell morphology was observed by an invert microscope and cell cycle of the primary and P2 cells were detected by flow cytometry after proliferation in monolayer culture.[Result]1.Primary culture cells of nucleus pulposus grew well in the medium,and 90% cells adhere to layer after about 7d.2.The rate of apoptosis of NP: primary(38.10?11.7)%,P2(44.74?17.6)%.The rate of S period : primary(7.88?2.1%),P2(2.76?0.7)%.[Conclusion]When going down to posterity the cells' apoptosis rate grows while S period cells decrease.
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Objective To explore the diagnosis and treatment of primary small bowel tumors. Methods The clinical data of 58 cases of primary small bowel tumors were retrospectively analyzed. Results Fifty-eight cases of primary small intestinal tumors were comfirmed by operation and/or pathology .Of them,19 suffered from benign tumors and 39 from malignant tumors.The main clinical manifestations of small bowel tumors were abdominal pain, abdominal mass, ileu and upper gastrointestinal hemorrhage.Twenty cases were diagnosed before the operation,and the misdiagnosis rate was 65.5%.All the 19 benign small intestinal tumors underwent local intestinal resection.In 39 malignant cases,18 underwent radical excision of the tumors, 6 received palliative excision and 5 underwent intestinal bypass operation. One patient died after the operation.The 1,3,5 -year survival rate of malignant tumors was 57.1%,28.6%and 9.5% respectively. Conclusions Primary small bowel tumor is uncommon and easy to be misdiagnosed.So attention must be paid to this disease.Endoscopy, X-ray ,BUS, CT and capsule endoscopy are the ideal diagnostic methods for small intestinal tumors .
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Objective To analyse the clinical characteristics,diagnosis and treatment of gastric schwannoma. Methods The clinical data of 9 patients with gastric schwannoma were retrospectively analysed. Results The main manifestation in this series was as follows:abdominal pain(9 cases), abdominal mass(5 cases) and upper gastrointestinal hemorrhage(3cases).All the patients underwent surgery.None was diagnosed before the operation, 1 patient with malignant gastric Schwannoma died 8 months after the operation.The effect of operation for benign gastric schwannoma was nice.Conclusions Gastric schwannoma has no specific clinical characteristics preoperatively,and the misdiagnosis rate is high.Once the diagnosis of gastric Schwannoma is made,an operation should be performed as early as possible.