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Objective:To investigate the relationship between vaccination doses and the duration of positive nucleic acid or antigen tests in Corona Virus Disease 2019 (COVID-19) patients during omicron epidemic.Methods:A cross-sectional study was conducted from December 26 to December 31, 2022 among COVID-19 patients from all community health service centers in 16 districts of Beijing municipality selected by multi-stage stratified cluster quota sampling method. A questionnaire was used to collect the basic information, vaccination doses, results of nucleic acid or antigen tests of all subjects. The subjects were divided into 5 groups according to the doses of COVID-19 vaccination: the non-vaccination group, the 1, 2, 3 and 4 doses vaccination group. The relationship between vaccination doses and the duration of positive nucleic acid or antigen tests was analyzed by univariate and multivariate logistic regression models.Results:A total of 10 506 COVID-19 cases were included in the study with the age of (43.3±13.7) years. The duration of positive nucleic acid or antigen tests was longer than 7 days in 59.4%(276/465), 51.5%(67/130), 50.6%(355/701), 46.1% (3 464/7 520) and 39.2%(662/1 690) of non-vaccination, and 1, 2, 3, 4 dose vaccination groups, respectively ( P<0.001). Multivariate logistic regression analysis showed that compared with non-vaccination patients, the vaccination dose was an independent protective factor for duration of positive nucleic acid or antigen tests>7 days, and the OR values were 0.7 (95% CI 0.5-0.9, P=0.015), 0.6 (95% CI 0.5-0.8, P<0.001) and 0.5 (95% CI 0.4-0.6, P<0.001) for 2, 3 and 4 doses of vaccination, respectively. Conclusion:The vaccination doses are independently related to the duration of positive nucleic acid or antigen tests in COVID-19 patients and the risk is gradually decreases with the increasing vaccination doses.
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Objective:To understand the status of knowledge, attitude and practice of metabolic syndrome(MS) among the elderly in the community and analyze its influencing factors, so as to provide guidance for the prevention and treatment of MS.Methods:From January 2021 to August 2021, permanent residents(residence duration ≥6 months)aged 65 and above with regular health check examination in Fangzhuang Community Health Service Center of Fengtai District, Beijing were investigated using self-designed MS knowledge, attitude and practice questionnaire.After excluding 34 incomplete questionnaires, the 491 valid questionnaires were recycled with questionnaire valid percentage of 93.5%(491/525). The survey results were analyzed by descriptive analysis, Mann-Whitney U test, Kruskal-Wallis H test and multiple linear regression analysis and multiple linear regression.Results:The scores of MS knowledge, attitude and practice of the elderly in the community were 7(5, 10), 9(8, 10)and 19(18, 21)respectively.The correct answer rate of the diagnostic criteria of MS components was less than 50%.The score of knowledge about MS in the elderly was positively correlated with the scores of attitudes( r=0.263)and practice( r=0.134)(all P<0.01). The results of univariate and multiple linear regression analysis showed that gender, attending educational lectures and the prevalence of MS were the influencing factors of MS knowledge score(all P<0.05). Leisure time, attending educational lectures, pre-retirement occupation and regular health check examination were the influencing factors for MS attitude score(all P<0.05); attending educational lectures, leisure time, regular health check examination and pre-retirement occupation were the influencing factors for MS practice score(all P<0.05). Conclusions:The elderly in the community have a low level of knowledge about the components and diagnostic criteria of MS, but have a positive attitude and practice towards the prevention and treatment of MS.The level of knowledge, attitude and practice of MS is affected by health education lectures, occupation, regular health check examination and other factors.Health education on the diagnostic criteria and the awareness of disease prevention for the elderly in the community should be strengthened to improve the levels of the knowledge, attitude and practice of MS.
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Objective To investigate the prevalence of metabolic syndrome and appropriate cut-off point of waist circumference of abdominal obesity for components of metabolic syndrome in Uygur population in Xinjiang. Methods A questionnaire-based survey, physical examination, and blood testing were conducted according to cluster random sampling in Uygur residents above 18 years old in Xinjiang.There were 3 542 samples collected,based on the International Diabetes Federation(IDF)standard of metabolic syndrome, the relativities of clustering of metabolic syndrome components and different strata of waist circumference for Uygur were analyzed,and looking for the appropriate cut-off points for identifying two or more components of metabolic syndrome within the shortest distance of receiver operating characteristic(ROC)curve.Results According to IDF standard,the waist circumference(85 cm for men,82 cm for women)corresponded to the shortest distance in ROC curve,at these cut-offs of abdominal obesity for component of metabolic syndrome,the prevalences of metabolic syndrome were 21.3%,19.5%in men, while 23.0%in women,the prevalence of women was higher than that of men(P<0.05).The prevalences of≥1,≥2 components of metabolic syndrome were shown an increasing trend with the increasing size of waist circumference, and the odds ratio of clustering of metabolic syndrome components were also increased significantly.Conclusion The prevalence of metabolic syndrome among Xinjiang Uygur population was higher than that of national level.The cut-off points of waist circumference(85 cm for men,82 cm for women)combining other components definition of IDF standard were recommended for identifying metabolic syndrome of Uygurs.
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Objective To explore the regulation and effect factors of arsenic expose and arsenic methylation level, then to provide a reference for study the function of arsenic metabolism in a arsenic poisoning process. Methods A meta-analysis was performed by two researchers. Twenty-five papers satisfying our priori eligibility criteria were included by searching Cochrane library, Pubmed, Springer, Embase and China National Knowledge Infrastructure. Based on the results of heterogeneity, a random or fixed effects model was chosen for the meta-analysis. Results The results showed that the following arsenic metabolites increased (all P<0.01) following arsenic exposure: inorganic arsenic [iAs; standardized mean difference (SMD): 1.07; 95% confidence interval (CI):0.61 - 1.53)], monomethyl arsenic (MMA; SMD: 1.10; 95% CI: 0.81 - 1.40), dimethyl arsenic (DMA; SMD: 2.50;95%CI:1.50-3.69), and total arsenic (TAs, SMD:3.10;95%CI:2.13-4.07). Additionally, the percentages of iAs (iAs%; SMD: 1.00; 95% CI: 0.60 - 1.40) and MMA (MMA%; SMD: 0.49; 95% CI: 0.21 - 0.77) also increased, while the percentage of DMA (DMA%; SMD: - 0.55; 95% CI: - 0.80 - - 0.31) decreased (P<0.01). The primary methylation index (PMI; SMD: - 0.57; 95% CI: - 0.94 - - 0.20), and secondary methylation index (SMI;SMD: - 0.27; 95% CI: - 0.46 - - 0.09) decreased (all P< 0.01). Compared to female, male had higher MMA%(SMD:0.44;95%CI:0.35-0.52), lower DMA%(SMD:-0.33;95%CI:-0.38--0.28) and SMI (SMD:-0.36;95%CI:-0.53--0.19). The smoker had higher MMA%(SMD: 0.22; 95%CI: 0.07 - 0.37) and lower DMA%(SMD:-0.16;95%CI: - 0.26 - - 0.05). The drinker had higher MMA% (SMD: 0.17; 95% CI: 0.07 - 0.27) and lower DMA%(SMD:-0.24;95%CI:-0.39--0.10). The older people had higher MMA%(SMD:-0.23;95%CI:-0.40--0.06). In addition, the body mass index may influence the percentages of MMA (SMD: - 0.18; 95% CI: - 0.31 - - 0.04, P < 0.01). Conclusion Arsenic exposure, smoking, drinking, and older age can reduce the capacity of arsenic methylation. Arsenic methylation is more efficient in women than in men.
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according to the difference of femoral eccentricity on the affected and healthy sides. In the reduction group (30 cases), the difference value was 5 mm. Femoral stem and femoral prosthesis type were compared among different groups. SF-12 scale score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Harris score were evaluated and compared before and after replacement. RESULTS AND CONCLUSION:Standard eccentricity of femoral prosthesis mainly accounted for 77%, 63% and 73% in the reduction group, normal group and increased group, respectively (P > 0.05). No significant difference in average eccentricity was detected in each group between the affected and healthy sides (P> 0.05). WOMAC score was significantly higher after replacement than that before replacement in three groups (P 0.05). No significant differences in pain and stiffness were detected among three groups after replacement (P > 0.05), and significant differences in physical function were found (P 0.05). The physical ability score was elevated after replacement in the three groups (P < 0.05). Mental scores were significantly elevated in reduction and normal groups (P < 0.05). The excelent and good rate of Harris score was significantly higher in the increased group (96%) than in the reduction group (70%) and normal group (87%) (P < 0.05). These findings indicate that the increased eccentricity contributed to the pain easement after total hip arthroplasty and promoted functional recovery. The decreased eccentricity could worsen patient’s pain, and was not conducive to the restoration of joint function after replacement.
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Objective To explore the applications of case analysis learning and traditional teaching method in clinical practice teaching effect for students majoring rehabilitation therapy in the course of musculoskeletal rehabilitation.Methods 83 program students of Rehabitation Therapeutics in grade 2011 were chosen to participate in the clinical practice teaching in the course of musculoskeletal rehabilitation of 12 credit hours.Class 1 was taught by the traditional teaching method,while Class 2 was taught by the case analysis learning,making clinical case analysis,practical operation and case discussion working as teams.After learning,we made an analysis of two classes through the form of theory examination,practical operation and the questionnaire.The evaluation scores were shown by (x ± s)and comparison was made between the two groups with t test after SPSS software for statistical analysis.Results Taught by the case analysis,the theoretical performance of Class 2 was (83.37 ± 5.59),better than Class 1 (80.85 ± 6.98),but the difference was not statistically significant (P=0.056),but in the practice operation the achievements of Class 2 were (72.65 ± 8.05) points better than Class 1 (66.49 ± 12.86),and the difference was statistically significant(P=0.024).The survey results showed that in Class 2 which adopted case analysis teaching,students' satisfaction was higher than that of Class 1 which kept traditional teaching,and the difference was statistically significant(P＜0.05).Conclusion Case analysis teaching in musculoskeletal rehabilitation application effect is better than the traditional teaching in clinical practice teaching and can be extended to other clinical teaching of rehabilitation therapy specialty.
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Objective: To observe the characteristics of serum homocysteine (Hcy) distribution and the epidemiological characteristics of high serum level of Hcy (HHcy) in Kazakh population. Methods: The stratiifed cluster random sampling method was used to investigate 1003 kazakh individuals in Xinyuan county of Xinjiang including 433 male and 570 female, and they were individuals into 5 age groups:①(25-34) years, n=333,②(35-44) years, n=306, ③(45-54) years, n=230, ④(55-65) years, n=90, ⑤>65 years, n=44. The questionnaire survey, physical check-up and blood biochemical examination were performed and compared among different groups. Results: ① The geometrical mean of Hcy was 13.3μmol/L, and the male was higher than female as 16.0μmol/L vs 11.6μmol/L. ②By age stratiifcation, the serum levels of Hcy elevated with the increased age accordingly. Except for those with the age>65 years, the serum levels of Hcy were all higher in male than female in other 4 age groups. ③The average rate of HHcy prevalence was 31.5%, and the male was higher than female as 49.9%vs 17.5%.④The average rate of H type hypertension prevalence was 35.1%, and the male was higher than female as 44.3%vs 28.1%. There were 87.6%of H type hypertensive patients with H type hypertension, and the male was higher than female as 95.0%vs 80.0%, all P Conclusion: The serum levels of Hcy were different from gender and age; the prevalences of HHcy and H type hypertension were higher in Kazakh population at Xinyuan county of Xinjiang. Community intervention should be conducted to improve the public health condition in Kazakh population.
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Objective To analyze the clinical results of 360° fusion for spondylolisthesis.Methods Data of 76 patients from March 2005 to November 2012,including 26 males and 50 females with a mean age of 54.3 years were retrospectively analyzed.All patients had undergone modified 360° fusion.The clinical outcomes were evaluated by the Japanese Orthopaedic Association scores (JOA) and visual analogue scale (VAS).The fusion status and loss of correction were assessed by CT and plain radiographs.Results All patients had been successfully followed up for at least one year.Post-operative reduction rate was 96.8％,with a mean loss rate of 1.1％ at six months and 0.8％ at one year follow-up separately,but the difference was not significant.Postoperative percentage of slip,lumbar lordosis,intervertebral disc height and slip angle had significant differences,compared with those of the pre-operative,but the difference between one week post-operative,six months follow-up and one year follow-up were not significant.The fusion rate was 76.3％ at six months follow-up and 98.7％ at one year follow-up,and there were significant differences.Both JOA and VAS score at six months and one year follow-up indicated significant differences in contrast to that of preoperative.Dural injury was found in one patient,and subsidence was found in one patient.One received a second operation at 3 months after the surgery due to screw loose.Conclusions Modified 360° fusion shows great clinical outcome and fusion rate,which can be a dominant procedure for treating spondylolisthesis.
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ObjectiveTo analyze the prognosis of the new occurred proximal thoracic(PT) curve after posterior correction surgery in adolescent idiopathic scoliosis (AIS) patients.MethodsThe radiographs of 21 AIS patients,who had a primary main thoracic (MT) curve and suffered from a new PT curve after posterior correction surgery,were retrospectively reviewed.All patients were followed up for an average of 19.8 months.Imaging parameters including coronal Cobb angle,T1 tilt and radiographic shoulder height,were measured and analyzed.ResultsThe average coronal Cobb angle of the MT curve was 54.3° preoperatively,14.1° at the final follow-up,with an average correction rate of 74.6％.Before operation,5 patients had negative T1 tilt and 16 without T1 tilt.After operation,all the 21 patients had positive T1 tilt and new PT curves;the average T1 tilt was 6.0° and the average coronal Cobb angle of the PT curve was 16.0°.At the final follow-up,the average T1 tilt and coronal Cobb angle of the PT curve were 4.0° and 13.2°,respectively; eighteen patients still had positive T1 tilt and 17 patients still had PT curves larger than 10°.As for the radiographic shoulder height,5 patients had equal shoulders and 16 patients had right shoulder elevation before operation; after operation,19 patients had left shoulder elevation and 6 patients had unbalanced shoulders; at the final follow-up,14 patients still had left shoulder elevation and 5 patients had unbalanced shoulders.At the final follow-up,T1 tilt and coronal Cobb angle of the PT curve were better than those postoperatively immediately,while the incidences of the new PT curve,left shoulder elevation,unbalanced shoulders were all not significantly different from those postoperatively immediately.ConclusionThe new occurred PT curves after posterior correction surgery in AIS patients are difficult to be compensated and could cause shoulder imbalance,thus great attention should be paid to prevent the occurrence of the PT curve.
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Objective To introduce a new spinal surgery navigation system based on structured light scanning(structured light navigation system,SLNS),and to compare accuracy of pedicle screw placement using SLNS,CT based navigation system and free hand technique.Methods Thirty-two calf vertebral pedicles,40 and 32 were placed with pedicle screws using SLNS,CT navigation system,and free hand technique,respectively.The pedicle breakage ratio,transverse section angle (TSA),sagittal section angle (SSA),screw offset deviation of each screw were detected according to CT images.Results The pedicle breakage ratio of pedicle screws in SLNS group,CT navigation group and free hand group were 6%(2./32),5%(2/40),25%(8/32),respectively.The difference between each of the two navigation groups and free hand group were statistically significant regarding frequency of screw misplacement.The difference between the two navigation systems was not obvious.The average SSA error and TSA error in SLNS group were 2.58°±2.74° and 4.26°±5.20°.For CT navigation group,they were 2.95°±2.61° and 3.13°±-2.75°.There was no statistical difference between the two navigation methods for the SSA or TSA error.There was no statistical difference in offset deviation among SLNS group,CT navigation group and free hand group.Conclusion The SLNS is a new and practical navigation system,which has similar accuracy with CT navigation system.
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Objective To retrospectively analyze the application of single and dual growing rod techniques in treatment of early onset scoliosis,and compare the early results of two techniques.Methods Retrospective study was done on 18 cases of early onset scoliosis treated with growing rod technique from November 2002 to March 2009.Single growing rod group included 5 cases and dual growing rod group included 13 cases.We compared the operation time,intra-operative bleeding,correction rate,changes in distance between C7-S1 and incidence of complications of the first operation between two techniques.Results The average post-operative follow-up duration was 39.9 months (14-89).There was no difference in operation time,intra-operative bleeding and incidence of complications between two techniques.There was no difference in preoperative coronal Cobb angle and preoperative sagittal Cobb angle between single growing rod group and dual growing rod group.Correction rate of dual growing rod group was significantly superior to single growing rod group in coronal plane (P＜0.01),but not in sagittal plane.Increase of the distance between C7-S1 dual growing rod group was significantly larger than the single growing rod group (P＜0.05).Conclusion Growing rod technique is an effective option for early onset scoliosis.Dual growing rod technique is relatively superior to single growing rod technique in correction outcomes.
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BACKGROUND: Recently, trans-pedicle screw internal fixation has markedly improved the rigidity of spinal fixation and hence the fusion rate. But when placed incorrectly, the pedicle screw can injure the spinal cord and/or nerve roots, resulting in serious complications.OBJECTIVE: To evaluate the application value of preoperative CT scans-based navigation technique in the spinal pedicle screw internal fixation surgery.DESIGN, TINE AND SETTING: A prospective, randomized, and controlled observation was performed at the Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences between January 2006 and December 2008.PARTICIPANTS: A total of 95 patients who underwent pedicle screw internal fixation due to spine diseases were randomly assigned to a navigation group (n = 45) and a conventional group (n = 50).METHODS: In the navigation group, patients were subjected to pedicle screw insertion with the assistance of computer navigation technique and while in the conventional group, patients underwent pedicle screw insertion using the conventional anatomic landmark combined with fluoroscopy.MAIN OUTCOME MEASURES: Screw channel preparation time, excellent and good rate of screw position, and postoperative complications.RESULTS: In the navigation group, totally 206 pedicle screws were inserted under navigation guidance, with an excellent and good rate of 96.1%; and navigation could not be continued in 9 patients for a three-dimensional registration error. In the conventional group, altogether 285 pedicle screws were inserted, and the excellent and good rate was 100%. No significant difference was found between the two groups (P > 0.05). The navigation group exhibited longer screw channel preparation time than the conventional group [(360±22) seconds vs. (56+8) seconds, P < 0.01]. No postoperative complications were found in each group.CONCLUSION: The preoperative CT scans-based navigation technique produces similar accuracy of pedicle screw insertion, but markedly prolonged operation time, compared with the conventional anatomic landmarks, exhibiting limited application value in the spinal pedicle screw internal fixation.
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CT data regarding PUMCⅡ d2 adolescent idiopathic scoliosis obtained from one female patient were input into modeling software minics 11.11 to obtain medical simulation model.Then finite element analysis models of AIS patients (T1-S) were created by introducing simulation models into software abaqus 6.7.Finite element models of T6 11 segments were corrected by 5 different correction methods:simple concave bracing,simple convex pressurization,concave distraction and convex compression simultaneously,concave distraction prior to convex compression and concave distraction after convex pressurization.Abaqus software was used to simulate correction of scoliosis with vertebral arch pedicle screw by loading 50 N,100 N,and 200 N distraction forces on the concave side pedicles of the end vertebrae T6 and T11.The displacement of vertebrae T6 in Y-axis (sagittal plane) and Z-axis (coronal plane),which respectively represented the correction effects of kyphosis and scoliosis,was compared between prior to and after correction.Simple concave distraction provided better outcomes in terms of displacement of T6 in Z-axis than the remaining four methods (P ＜ 0.01).Concave distraction and convex compression simultaneously,concave distraction prior to convex pressurization and concave distraction after convex compression produced identical displacements of T6 in Y-axis,which were all better than simple concave distraction (P＜ 0.01).The present findings imply that for curative effects of five methods on correction of scoliosis in the coronal plane:simple concave distraction＞ concave distraction and convex compression simultaneously = concave distraction prior to convex compressio= concave distraction after convex compression ＞ simple convex pressurization;for curative effects of five methods on correction of kyphosis in the sagittal plane:simple convex compression ＞ concave distraction and convex compression simultaneously = concave distraction prior to convex compression= concave distraction after convex compression＞ simple concave bracing.Simple concave distraction could not produce obvious corrective effects on kyphosis rather than lead to worsened kyphosis to some extent.Simple convex compression could not produce obvious corrective effects on scoliosis rather than result in aggravated scoliosis to some extent.
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OBJECTIVE: To study the effects of Tongbi Mixture 2, a compound traditional Chinese herbal medicine for treating rheumatoid arthritis (RA), on immunoregulation of T lymphocytes in rats with collagen-induced arthritis (CIA). METHODS: Forty Wistar rats were randomly divided into normal control group, untreated group, Tongbi Mixture 2-treated group, methotrexate (MTX)-treated group and Tripterygium wilfordii polyglycoside (TWP)-treated group. Except for the rats of the normal control group (injection with normal saline), rats of the other four groups were subcutaneouly multipoint-injected with collagen protein II to induce CIA. The rats were treated with normal saline, Tongbi Mixture 2, MTX tablets and TWP tablets respectively for 36 days. The expressions of CD28 and CD152 were detected by flow cytometry, while the content of tumor necrosis factor-alpha (TNF-alpha) was analyzed by enzyme-linked immunosorbent assay. RESULTS: The expression of CD28 among the three drug treated groups had no statistical difference (P>0.05), while significantly higher than that of the normal control group (P0.05). There were no statistical differences in content of TNF-alpha between the drug treated groups and the normal control group (P>0.05), but the content of TNF-alpha of the drug treated groups was lower than that of the untreated group (P<0.05 or P<0.01). CONCLUSION: Tongbi Mixture 2 can inhibit T lymphocytes through down-regulating the expressions of CD28 and CD152 and the content of TNF-alpha, which may be the major mechanisms in treating RA.
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This study evaluates the immediate effects of the endocardial electrical defibrillation delivered by two transvenous defibrillation systems on left ventricular (LV) function in the animal model. Automatic cardiac defibrillation systems with bipolar leads (group I) and tripolar leads (group II) were placed in the hearts of 10 dogs (group I) and 10 pigs (group II),respectively. Transesophageal echocardiography with two dimensional image, M-mode and pulse Doppler were performed at baseline and after several episodes of defibrillation (DF). Each animal in group 1 underwent 4 DF with 64 Joules; the animals in group2 underwent an average of 8 DF with a total of 210 Joules. LV fractional area contraction, isovolumic relaxation time, and both ratios of velocities and time-velocity integrals in transmitral Doppler flow E and A waves exhibited no significant change after the shocks. This study suggests that the repeated low-energy electrical countershocks delivered by two transvenous defibrillation systems do ndt cause LV global systolic and/or diastolic dysfunction.
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Animals , Dogs , Female , Male , Echocardiography, Transesophageal , Electric Countershock , Methods , Swine , Therapy, Computer-Assisted , Methods , Ventricular Fibrillation , Therapeutics , Ventricular Function, Left , PhysiologyABSTRACT
This study is to quantify time-varying dominant frequencies in electrocardiogram (ECG) during the ventricular fibrillation (VF). Orthogonal ECG (sagittal, x; transverse, y; and longitudinal, z) and the transvenous two-leads defibrillation systems were set in 19 dogs. Time-frequency analysis was used to assess changes in the dominant frequency within ECG recorded in dogs during trials of 10-30 s of VF. In 4 additional dogs, the dominant frequencies were compared during 10 s of VF before and after administration of amiodarone. Results showed that in the 427 trials of 10 s VF and 335 trials of 30 s VF, average variation in the dominant frequency was considerable, between +/- 12%-18%. The frequencies orthogonal ECG during 10 s VF were distributed symmetrically above and below the mean frequency like a normal distribution. In the 79 trials with administration of amiodarone during 10 s VF in all three ECG, the mean frequencies decreased from 6.5 (x), 7.4 (y) and 7.0 Hz (z) to 6.1, 6.4 and 6.3 Hz (P < 0.01), respectively, and the variation in dominant frequencies decreased from 1.18, 1.38 and 1.19 to 0.98, 1.11 and 1.02 Hz (P < 0.05) respectively. The results confirmed that the frequencies of 10-30 s VF in ECG vary considerably and continuously, and amiodarone decreases this variation.
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Animals , Dogs , Female , Male , Amiodarone , Pharmacology , Anti-Arrhythmia Agents , Pharmacology , Electric Countershock , Electrocardiography , Ventricular FibrillationABSTRACT
Recombinant human interleukin-1 receptor antagonist was expressed in E. coli as an insoluble inclusion body. The inclusion body was dissolved in the 8 M urea and then the solution was diluted untill the concentration of urea became 2 M. By ion exchange chromatography the protein in the solution of 2 M urea was refolded and purified. At last the purity of product is more than 95% and its bioactivity is more than 1 x 10(5) IU/mg while it has little endotoxin. Western-Blotting also indicates that recombinant protein can react with antibodies against anti-hIL-1ra.
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Humans , Escherichia coli , Genetics , Metabolism , Inclusion Bodies , Metabolism , Interleukin 1 Receptor Antagonist Protein , Genetics , Protein Folding , Recombinant Proteins , GeneticsABSTRACT
BACKGROUND: Low back pain and low limb disability are classical symptoms of patients with degenerative lumbar spondylolisthesis who are often treated with operative internal fixation.OBJECTIVE: To observe the improvement of low-back pain and low-limbs disability of patients with degenerative lumbar spondylolisthesis following the treatment with general spine system(GSS).DESIGN: Self control clinical study with patients as subjects.SETTING: Department of Orthopaedics, Peking Union Medical College Hospital.PARTICIPANTS: Sixteen patients with degenerative lumbar spondylolisthesis combined with lumbar stenosis, including 10 males and 6 females with the average age of 58.5 years(ranged from 42 to 72 years) received treatment in our hospital between September 2001 and December 2001. Patients with low back pain were found in 16 cases and low-limb claudication in 15cases; preoperative spondylolisthesis of grade I was observed in 10 cases and grade Ⅱ in 6 cases.METHODS: After receiving lumbar canal decompression by spinal process and GSS for restoring spondylolisthetic vertebra, as well as internalfixation and lumbar fusion operation, patients were followed up at postoperative week 2 and month 1,3,6,12,18,24 for assessing the low-back pain and low-limb disability and meanwhile preoperative spondylolisthesis and postoperative restroration were also assessed with X-ray.RESULTS: Totally 16 patients were followed up for an average of21.2appeared in 15 out of 16 patients, and intermittent claudication resumed to time of follow-up revealed that all spondylolisthetic vertebra were restored with restoring rate of 100% (16/16).CONCLUSION: GSS was proved of satisfactory therapeutic effect in patients with spondylolisthesis by obviously improving their low-back pain and intermittent claudication.
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BACKGROUND: Spinal somatosensory evoked potential(SEP) monitoring is widely used intraoperatively due to the easiness to operate and its reliability.OBJECTIVE: This study was designed to assess the significance of improving SEP signals in intraoperative spinal monitoring on predicting the post-operative spinal function.DESIGN: A non-randomized concurrent controlled study was conducted on selected patients.SETTING: This study was conducted at the Orthopedic Department of Peking Union Medical College Hospital.PARTICIPANTS: Totally 34 patients with cervical spondylosis underwent surgical treatment at the Orthopaedic Department of Peking Union Medical College Hospital were selected from January to October in 2001. Of all the patients, 24 underwent anterior decompression and fusion, 3 single door operation and 7 double door operation. According to the variance of intraoperative SEP, the patients were divided into the improvement group(12 cases)and the non-improvement group(22 cases).METHODS: All the patients' neurologic deficits were assessed according to the Japanese Orthopaedic Association scoring system(JOA score), prior to operation and postoperative week 1, 2, and 4 and month 3, 6. Each patient received the intraoperative spinal SEP monitoring. The variance of SEP signals in amplitude and latency were classified as improvement(an increase in amplitude of 50% or more, or a decrease in latency of 10% or more), decrease(a decrease in amplitude of 50% or more, or an increase in latency of 10% or more), and no improvement.MAIN OUTCOME MEASURES: JOA scores were calculated in two groups in the study at all time points.RESULTS: All the 34 patients entered the statistical analysis procedure. In postoperative week 1 and week 2, the improvement group showed a larger increase in JOA score than the non-improvement group did[improvement group:(14.08±1.44), (14.17±1.11) points; no improvement group:( 12.73 ± 1.42), ( 12.86 ± 1.28)points, P ＜ 0.05]. In postoperative week 4, month 3 and month 6, both groups showed an increase in JOA scores [improvement group: (14.00±1.04), (13.58±1.08), (13.68±1.61)points; no improvement group: (13.82 ± 1.01), (13.41 ± 1.22), (13.41± 1.47)points], but there was no significant difference( P ＞ 0.05).CONCLUSION: Improvement of intraoperative SEP can be used to predict the good early clinical outcomes in surgery for cervical spondylosis.
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<p><b>OBJECTIVE</b>To discuss the causes and treatments of wound infections after scoliosis surgery.</p><p><b>METHODS</b>Nine hundred and twenty-four caes of scoliosis were reviewed, and the clinical data of 15 cases of postoperative infection were analysed retrospectively.</p><p><b>RESULTS</b>All 15 cases underwent spinal posterior fusion with autologous bone graft using instrumentations. Seven were diagnosed as early infection, and 8 were delayed infection. Radical debridement was performed in all 15 cases. The duration of antibiotics administration was 10 to 34 days with continuous closed irrigation for 2 to approximately 4 weeks and primary closure for the wounds. All patients were followed up for an average of 3.5 years (2 to 7.5 years) with good outcomes and no recurrence.</p><p><b>CONCLUSION</b>Wound infection following surgical correction of scoliosis primarily results from intraoperative seeding, although host-related and operation-related factors may contribute to its development. Once the infections are diagnosed, good results can be achieved by prompt surgical debridement, irrigation and reasonably administered antibiotics. Removal of hardware may be necessary in deep infections.</p>