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OBJECTIVES@#Primary trigeminal neuralgia (PTN) is a common cranial nerve disease in neurosurgery, which seriously endangers the physical and mental health of patients. Percutaneous balloon compression (PBC) has become an effective procedure for the treatment of PTN by blocking pain conduction through minimally invasive puncture. However, the recurrence of facial pain after PBC is still a major problem for PTN patients. Intraoperative balloon shape, pressure and compression time can affect the prognosis of patients with PBC after surgery. The foramen ovale size has an effect on the balloon pressure in Meckel's lumen. This study aims to analyse the predictive value of foramen ovale size for postoperative pain recurrence of PBC by exploring the relationship between foramen ovale size and postoperative pain recurrence of PBC.@*METHODS@#A retrospectively analysis was conducted on the clinical data of 60 patients with PTN who were treated with PBC in Department of Neurosurgery, Affiliated Hospital of Chengde Medical College from November 2018 to December 2021. We followed-up and recorded the Barrow Neurological Institute (BNI) pain score at 1, 3, 6 and 12 months after operation. According to the BNI pain score at 12 months after surgery, the patients were divided into a cure group (BNI pain score I to Ⅱ) and a recurrence group (BNI pain score Ⅲ to Ⅴ). The long diameter, transverse diameter and area of foramen ovale on the affected side and the healthy side of the 2 groups were measured. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used for analysis the relationship between the recurrence of pain and the long diameter, transverse diameter, area of foramen ovale on the affected side, and aspect ratio, transverse diameter ratio, area ratio of foramen ovale on the affected side to healthy side in the 2 groups.@*RESULTS@#At the end of 12 months of follow-up, 50 (83.3%) patients had pain relief (the cured group), 10 (16.7%) patients had different degrees of pain recurrence (the recurrence group), and the total effective rate was 83.3%. There were no significant differences in preoperative baseline data between the 2 groups (all P>0.05). The long diameter of foramen ovale on the affected side, the long diameter ratio and area ratio of foramen ovale on the affected/healthy side in the cured group were significantly higher than those in the recurrence group (all P<0.05), and there were no significant differences in the transverse diameter and area of foramen ovale on the affected side and the transverse diameter ratio of foramen ovale on the affected/healthy side between the 2 groups (all P>0.05). The ROC curve analysis showed that the AUC of the long diameter of foramen ovale on the affected side was 0.290 (95% CI 0.131 to 0.449, P=0.073), and the AUC of aspect ratio of foramen ovale on the affected side to healthy side was 0.792 (95% CI 0.628 to 0.956, P=0.004). The AUC of area ratio of foramen ovale on the affected side to healthy side was 0.766 (95% CI 0.591 to 0.941, P=0.008), indicating that aspect ratio and area ratio of foramen ovale on the affected side to healthy side had a good predictive effect on postoperative pain recurrence of PBC. When aspect ratio of foramen ovale on the affected side to healthy side was less than 0.886 3 or area ratio of foramen ovale on the affected side to healthy side was less than 0.869 4, postoperative pain recurrence was common.@*CONCLUSIONS@#Accurate evaluation of the foramen ovale size of skull base before operation is of great significance in predicting pain recurrence after PBC.
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Humans , Retrospective Studies , Foramen Ovale , Treatment Outcome , Trigeminal Neuralgia/surgery , Pain, Postoperative/etiology , RecurrenceABSTRACT
Objective:To evaluate the diagnostic value of digital breast tomosynthesis (DBT) and digital mammography (DM) for radial lesions.Methods:The data of 76 patients (78 lesions) with radial lesions confirmed by operation and pathology on DBT between December 2016 and May 2020 in the Affiliated Hospital of Qingdao University were analyzed retrospectively. Taking pathological results as the gold standard, 78 lesions were divided into benign radial lesions ( n=46) and malignant radial lesions ( n=32), and their DBT features were compared. According to the standard of breast imaging report and data system (BI-RADS), the wheel-spoke structure, central density, overall size, central size and surrounding burr length of the two groups of radial lesions were compared on DBT. Results:The detection rates of DM and DBT for 78 radial lesions were 59.0% (46/78) and 100% (78/78), the difference had statistically significant ( P<0.05). The diagnostic accuracy rates of DM and DBT for 78 radial lesions was 65.2% (30/46) and 74.4% (58/78), the difference had no statistically significant ( P>0.05). The sensitivity, specificity, misdiagnosis rates, missed diagnosis rates of DM and DBT in the diagnosis of malignant radial lesions were 64.3%(18/28) and 84.4%(27/32), 66.7% (12/18) and 67.4%(31/46), 33.3%(6/18) and 32.6%(15/46), 35.7%(10/28) and 15.6%(5/32), respectively. The difference was not statistically significant ( P>0.05). There were significant differences in the overall size of lesions [18.0 (14.9, 29.2) mm, 26.5 (20.2, 34.9) mm], central size [3.5 (2.5, 4.5) mm, 4.5 (3.5, 5.5) mm] and peripheral burr length [(11±6) mm, (13±4) mm] between benign and malignant radial lesions on DBT ( P<0.05). When the central size of the lesion was 5 mm, there was significant difference in the distribution of benign and malignant radial lesions ( P<0.05), and when the overall size of the lesion was 2 cm, there was significant difference in the distribution of benign and malignant radial lesions ( P<0.05). Conclusion:DBT can improve the detection and diagnosis accuracy of radial lesions, and provide an important basis for clinicians to make surgical treatment decisions.
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The prevalence of functional constipation (FC) is increased in elderly population, and seeking for a simple, safe and effective treatment modality is of great importance.Aims: To assess the clinical efficacy and safety of abdominal acupoint massage in elderly FC patients.Methods: A total of 151 elderly patients with FC were enrolled and randomly assigned into three groups: group A was treated with bisacodyl 5 mg once a day orally, group B with massage on Guanyuan, Zhongwan and Tianshu acupoints three times a day and group C with their combination.The treatment course was 4 weeks.The stool frequency per week was recorded, and the Patient Assessment of Constipation Symptoms scale (PAC-SYM) was scored.Results: The baseline data were comparable among the three groups (P>0.05).When compared with those before treatment, there was an increase in stool frequency per week and decrease in overall and dimensional scores of PAC-SYM at 1, 2, and 4 weeks after the beginning of treatment in all the three groups (P<0.05).Bisacodyl was superior to acupoint massage for improving stool frequency, consistency and rectal symptoms (P<0.05), while acupoint massage was superior to bisacodyl for alleviating abdominal symptoms (P<0.05).Mild adverse effects were recorded in patients receiving oral bisacodyl, and no adverse effects were observed in patients receiving acupoint massage.Conclusions: Abdominal acupoint massage is safe and effective for improving stool frequency and constipation-associated symptoms especially abdominal symptoms such as abdominal pain and distention in elderly FC patients.
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Objective:To investigate the protective effects of paeoniflorin on myocardial ischemia/reperfusion ( MI/R) injury in rats. Methods:The rat model of MI/R injury was prepared by coronary artery ligation for 30 min followed by 2-hour reperfusion. Then the rats were randomly divided into 5 groups:sham group, model group, paeoniflorin group respectively at high, medium and low dose (20, 10 and 5 mg·kg-1, n=10). Paeoniflorin was respectively injected via tail vein 1 h before the operation and at the beginning of the reperfusion. The CK, LDH and SOD activities and MDA contents in serum of rats were examined, and the area of myocardial in-farction was also calculated after the reperfusion. Results:Paeoniflorin (20 and 10 mg·kg-1 ) could significantly reduce the area of myocardial infarction when compared with the model group (P<0. 05). Paeoniflorin could obviously inhibit the CK and LDH activities (P<0. 05 or P<0. 01) and enhance the SOD activity (P<0. 01) in serum of MI/R rats. The MDA content in paeoniflorin groups at high and medium dose was significantly lower than that in the model group (P<0. 05). Conclusion:Paeoniflorin pretreatment shows effectiveness against MI/R injury, which may be associated with the inhibition of lipid peroxidation.
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Virtual reality is the multi-dimensional sensorial environment produced by the computer, Users can play a part in this virtual environment by particular tools. This technology, possessing the characteristics of being lifelike, interactive and imaginative, plays more and more important part in the medical field. For example, in medical training, in physical and psychological treatments, this technology is of great value.