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Clinical practice is the critical stage of training medical students in basic clinical quality.For the current major issues,such as lack of clinical case resources,lack of teaching conditions,and less chances of practice for students,cases library combined with medical human patient simulator is used in extern's teaching.Through this teaching,the students can touch numerous and comprehensive clinical cases,grasp clinical techniques proficiently,predominate diagnosis and treatment of common diseases in Orthopaedics efficiently by using medical human patient simulator.The effect of clinical practice teaching is improved greatly.The practice of related teaching means and methods provides a new way for the reform of the practice teaching.
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BACKGROUND:It has been a hotspot in the treatment of spinal fracture by minimaly invasive approach.Compare with open operation,minimaly invasive surgery has less trauma,less bleeding,less tissue damage and shorter hospital stay.But no clinical study focuses on the reduction effect of minimaly invasive percutaneous screw fixation and maintenance of vertebral height.OBJECTIVE:To compare the difference of minimaly invasive percutaneous screw combined with articular process bone grafting and simple screw fixation in the treatment of thoracolumbar fracture on maintaining vertebral height.METHODS:Clinical data of 79 patients with T11-L2 thoracolumbar fractures (AO type: A1,A2,A3,B1) wereretrospectively analyzed.Among them,41 cases were treated by percutaneous pedicle screw fixation combined with articular process bone grafting,while 38 cases were treated by percutaneous pedicle screw fixation,from January 2010 to September 2013.Perioperative indicators in the two groups,visual analogue scale scores,and Oswestry Disability Index before and after surgery,as wel as at final folow-up were compared between the two groups.The anterior and posterior of vertebral height,the recovery of Cobb's angle were evaluated.RESULTS AND CONCLUSION:The patients in the grafting group were folowed up for 4-36 months and those in the non-grafting group were folowed up for 5-30 months,there was no significant difference in the folow-up time between the two groups (P=0.25).The operation time,intraoperative blood loss,postoperative ambulation time and hospital stay showed no significant difference between the two groups (P＞0.05).The folow-up results showed that,no significant difference was found in visual analogue scale scores and Oswestry Disability Index between the two groups (P＞0.05).However,the anterior and posterior of vertebral height,the recovery of Cobb's angle in the grafting group were significantly better than that in the non-grafting group (P＜ 0.05).The short-term efficacy and security are similar between the two surgery methods in the treatment of thoracolumbar fracture.However,minimaly invasive percutaneous screw combined with articular process bone grafting shows great advantages in recovering and maintaining the long-term stability.
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[Objective]To compare the short term outcome in treatment of degenerative lumbar stenosis with Coflex implant versus laminectomy and posterior interbody fusion along with pedicle screw system. [Methods]Thirty patients with degenerative lumbar stenosis were randomly divided into two groups.Fifteen patients in the control group were treated with laminectomy and posterior interbody fusion along with pedicle screw system. The other 15 patients in the experiment group were treated with Coflex implant. The parameters for assessment included operation time,intraoperative blood loss,hospital stay,pre- and postoperative JOA score,improvement rate and complication rate.[Results]Compared to the control,significant reduction was found in terms of operation time,intraoperative blood loss,and hospital stay in the experiment group.No significant difference was found regard to the improvement rate and postoperative JOA score. In addition ,there was no complication in the Coflex group during the follow-up.[Conclusion]Coflex implant is an effective,save and minimally invasive surgical method for the treatment of degenerative lumbar stenosis.
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AIM: To investigate changes of Ca 2+ activated potassium channels (K Ca) in autogenous vein grafts. METHODS: The contraction of venous ring was measured by means of perfusion in vitro. The intimal proliferation and proliferation of cultured smooth muscle cells (vascular smooth muscle cells, VSMCs) were observed by the means of computerised image analysis and MTT method, respectively. Furthermore, whole cell mode of patch clamp was used to record K Ca of VSMCs isolated from autogenous vein grafts. RESULTS: 1 week after transplantation there were no significant differences of contraction and intimal relative thickness between autogenous vein grafts and control. Contraction and intimal relative thickness of autogenous vein graft were significantly increased 2 weeks after transplantation (P