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1.
Article in Chinese | WPRIM | ID: wpr-879428

ABSTRACT

OBJECTIVE@#To compare the clinical outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction (ACLR) with a tibialis anterior allograft (TAA)versus hamstring tendon autograft (HTA) after 10 years follow-up.@*METHODS@#A clinical data of 107 patients who underwent arthroscopic ACLR with a single bundle tendon between March 2007 and March 2010 was retrospectively analyzed. Among the patients, 48 patients were reconstructed with a tibialis anterior allograft (TAA group), including 26 males and 22 females, ranging in age from 16 to 38 years, with a mean of 27.2±6.2 years;59 patients were reconstructed with a hamstring tendon autograft (HTA group), including 31 males and 28 females, ranging in age from 16 to 40 years, with a mean of 28.0±7.6 years. The preoperative tibial anterior displacement and knee joint function, as well as knee joint stability, tibial anterior displacement and knee joint function at 10 years after operation were observed. Lachman test was used to evaluate the forward joint stability and pivot shift test to evaluate the rotational stability of the knee;KT-2000 side-to-side difference (SSD) was used to measure tibial anterior displacement;International Knee Documentation Committee(IKDC) score and Lysholm score were used to evaluate knee function.@*RESULTS@#The incisions of both groups were healed by first intention, and no early complications occurred after operation. All patients were followed-up 10 to 13 years, the mean time was 11.7 years. There was no graft failure were found during the follow up period. The KT-2000 SSD of the TAA group and the HTA group at ten years after operation were 1.9±0.7 and 1.8±0.6 respectively, which were significantly improved than 8.8±0.9 and 8.6±1.0 preoperatively(@*CONCLUSION@#The TAA and HTA have equal long term effect in ACL reconstruction, doctors and patients can choose the graft according to the actual situation.


Subject(s)
Adolescent , Adult , Allografts , Anterior Cruciate Ligament/surgery , Anterior Cruciate Ligament Injuries/surgery , Anterior Cruciate Ligament Reconstruction , Arthroscopy , Autografts , Female , Hamstring Tendons , Humans , Knee Joint/surgery , Male , Retrospective Studies , Treatment Outcome , Young Adult
2.
Article in Chinese | WPRIM | ID: wpr-879386

ABSTRACT

OBJECTIVE@#To explore clinical effects of single-tunnel pullout structure fixation and anatomical reconstruction of lateral ligament complex in treating chronic lateral ankle instability.@*METHODS@#From January 2016 to December 2018, clinical data of 23 patients with chronic lateral malleolus instability who underwent anatomical reconstruction of lateral malleolus ligament complex with single-tunnel pullout structure fixation, were retrospectively studied. Among them, including 7 males and 16 females, aged from 17 to 33 years old with an avergae of (26.0±4.3) years old;16 patients classified to grage 0, and 7 patients classified to gradeⅠaccording to Kellgren-Lawrence(K-L) grading;the time of sprain ranged form 2 to 15 with an average of (5.7±2.9) times;the time from injury to operation ranged to 4 to 18 months with an average of (9.0±3.3) months. The range of movement of operative and uninjured ankle joints were measured at 24 months after opertaion, visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) were used to evaluate ankle joint function and improvement of pain, K-L grading and MRI scoring of osteoarthritis of ankle (MSOA) were used to evaluate degree of cartilage degeneration of ankle joint.@*RESULTS@#All patients were followed up from 24 to 48 months with an average of (33.4±6.7) months. All the anterior talofibular ligaments and calcaneofibular ligaments were dissected and reconstructed by single-tunnel pullout structure fixation. The range of motion of dorsiflexion, plantarflexion, varus, and valgus on the operative side of ankle joint were smaller than those on the healthy side. There were no statistically differences in dorsiflexion and eversion between operative side and healthy side of ankle joint (@*CONCLUSION@#Treatment of chronic lateral ankle instability with reconstruction of lateral ligament complex with single-tunnel pullout structure fixation could provide better tendon and bone healing conditions, improve surgical safety and could achieve satisfactory clinical outcomes.


Subject(s)
Aged , Ankle , Ankle Joint/surgery , Female , Humans , Infant , Joint Instability/surgery , Lateral Ligament, Ankle/surgery , Male , Retrospective Studies
3.
Article in Chinese | WPRIM | ID: wpr-826701

ABSTRACT

OBJECTIVE@#To observe the effect of acupuncture at "Baihui" (GV 20), "Zhongwan" (CV 12) and "Zusanli" (ST 36) on intestinal flora in rats with stress gastric ulcer (SGU) , and to explore the mechanism of acupuncture promoting SGU recovery.@*METHODS@#Thirty-one SPF SD rats were randomly divided into a control group (7 rats), a model control group (8 rats), an acupuncture group (8 rats) and a medication group (8 rats). The rats in the model group, acupuncture group and medication group were selected to applied the improved restraint water-immersion stress method to establish the SGU model. After modeling, the rats in the control group and model group were fixed and restrained for 20 min every day for a total of 5 days; the rats in the acupuncture group were intervented with acupuncture at "Baihui" (GV 20), "Zhongwan" (CV 12) and "Zusanli" (ST 36), once a day, 20 min each time, and twisting needle for 30 s every 5 min for a total of 5 days; the rats in the medication group were gavaged by solution of omeprazole enteric-coated tablet (200 mg/mL), 2 mL for each rat, once a day. Guth method was used to calculate the gastric mucosal damage index (GMDI), HE staining was used to observe the pathological changes of gastric mucosa, and 16SrDNA identification was used to detect the structural abundance of intestinal flora.@*RESULTS@#Compared with the control group, the GMDI of rats in the model group was increased (<0.01), the gastric mucosal pathological changes were significant, and the intestinal flora richness index Chao1, Observed species and diversity index Shannon were all decreased (<0.05), the diversity index Simpson was increased (<0.05). Compared with the model group, the GMDI of rats in the acupuncture group and medication group was reduced (<0.01, <0.05), the gastric mucosal damage degree was reduced, and the intestinal flora richness index Chao1, Observed species and diversity index Shannon were all increased (<0.05) and the diversity index Simpson decreased (<0.05). Compared with the medication group, the GMDI of rats in the acupuncture group was reduced (<0.01), the recovery of gastric mucosal injury was better than that of the medication group.@*CONCLUSION@#Acupuncture can effectively improve gastric mucosal injury of SGU, and the mechanism may be related to increasing the diversity of intestinal flora and promoting the correction of the disordered intestinal flora.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Animals , Gastrointestinal Microbiome , Random Allocation , Rats , Rats, Sprague-Dawley , Stomach Ulcer , Microbiology , Therapeutics
4.
International Eye Science ; (12): 1937-1941, 2020.
Article in Chinese | WPRIM | ID: wpr-829240

ABSTRACT

@#AIM: To evaluate the practical teaching effect of the doctor-patient communication ability training combined with Simulation-based Medical Education(SBME)pedagogy in the standardized training for ophthalmology residents through Mini-Clinical Evaluation Exercise(Mini-CEX). <p>METHODS: From September 2015 to July 2017, sixteen residents from the Department of Ophthalmology, the First Affiliated Hospital of Kunming Medical University were selected as research subjects. Before and after the conventional teaching or SBME teaching with standardized patients(SP), real doctor-patient communications were completed respectively, which were evaluated through Mini-CEX.<p>RESULTS: As to the Mini-CEX assessment of the standard training residents for the pre-intervention doctor-patient communication about the three common diseases of age-related cataract, primary open-angle glaucoma, and acute bacterial conjunctivitis, there was no significant difference in the average score of the seven items between the trainees in the control group and the experimental group(<i>P</i>>0.05). After the demonstration teaching and comment revision, the control group directly performed the post-intervention doctor-patient communication and Mini-CEX evaluation, and the experimental group performed the further SBME teaching and then the post-intervention doctor-patient communication and Mini-CEX evaluation. The scores of the seven items in the two groups after the intervention were significantly higher than those before the intervention(<i>P</i><0.05). The excellent rates of the trainees in the control group and the experimental group with an average score of 7 or more increased from 37.5%(3/8)and 37.5%(3/8)to 87.5%(7/8)and 100%(8/8), respectively. After the intervention, in addition to physical examination skills and clinical judgment, the scores of other five items such as medical interview skills, humanistic care and professionalism, psychological counseling skills, organizational effectiveness and overall clinical competence, were significantly higher in the experimental group than the ones in the control group(<i>P</i><0.05).<p>CONCLUSION: SBME pedagogy with SP can improve the effectiveness of the doctor-patient communication training for ophthalmology residents. Mini-CEX can be used to evaluate the teaching efficiency easily, quickly and standardly. The combination of Mini-CEX and SBME can be widely used in the practice of the doctor-patient communication training for ophthalmology residents.

5.
Article in Chinese | WPRIM | ID: wpr-828294

ABSTRACT

OBJECTIVE@#To evaluate the clinical effect of arthroscopic 360° capsular release with concomitant rotator cuff repair for patients with rotator cuff tears in global stiff shoulder.@*METHODS@#From December 2016 to December 2018, 247 patients full-thickness rotator cuff tear were treated with arthroscopic rotator cuff repair. Among them, 42 patients (17%) with global limitation of shoulder movement were treated with arthroscopic 360° capsular release operation at the same time of rotator cuff repair. The function of shoulder was evaluated by Constant-Murley score and visual analogue scales (VAS), flexion, abduction and external rotation on body side before and after operation. Sugaya classification was used to evaluatethe healing of rotator cuff. The number of shoulder dislocations during follow-up was recorded.@*RESULTS@#Thirty nine of the 42 patients were followed up for 12 to 36 (22±6) months. The patients were 43 to 73 (57±7) years old at the time of operation. The Constant- Murley score increased from (43.6±6.3) before operation to (87.5±2.8) at final follow-up (<0.001). VAS score decreased from (7.2±1.5) before operation to (1.0±0.9) at final follow-up (<0.001). The flexion of shoulder increased from (46±14)° before operation to (148±11)° after operation (<0.001), the abduction from (36±6)° before operation to (121±10)° after operation (<0.001), and the external rotation on body side from (5±10)° before operation to (42±8)° after operation(<0.001). One year after the operation, MRI showed thatⅠ-Ⅲ of Sugaya classification was clinical healing, 38 cases in total.@*CONCLUSION@#Arthroscopic 360° capsular release with concomitant rotator cuff repair was used to treat rotator cuff tear in global stiff shoulder. Themain observation indexes were improved after operation, and the clinical effect was definite.


Subject(s)
Adult , Aged , Arthroscopy , Humans , Joint Capsule Release , Middle Aged , Range of Motion, Articular , Rotator Cuff , Rotator Cuff Injuries , General Surgery , Shoulder , General Surgery , Shoulder Joint , Treatment Outcome
6.
Article in Chinese | WPRIM | ID: wpr-828229

ABSTRACT

OBJECTIVE@#To explore clinical diagnosis and treatment features of Maisonneuve fractures (maisonneuve fractures of the fibula, MFF), and evaluate its clinical effects.@*METHODS@#From March 2017 to June 2018, 15 patients with MFF were treated with operation, including 9 males and 6 females, aged from 27 to 54 years old with an average of (35.00±7.46) years old, the time from injury to operation ranged from 5 to 8 days with an average of (6.33±1.04) days. All the fractures were fresh and closed injury. The time of bone union and postoperative complications were observed, and AOFAS score was used to evaluate recovery of ankle joint function at 12 months after operation.@*RESULTS@#All patients were followed up from12 to 28 months with an average of (17.00±3.79) months. Four patients were misdiagnosed. All fractures were obtained bone union from 4 to 6 months with an average of (4.80±0.94) months. No postoperative complications such as infection, delayed union or nonunion occurred. Postoperative AOFAS score at 12 months was 90.23±7.27, among which 9 patients got excellent result, 3 good, and 3 fair.@*CONCLUSION@#Maisonneuve fracture is an unstable fracture. High fibular fracture and the separation of the lower tibia and fibula could be easily neglected, which could lead to misdiagnosis and missed care. Surgical treatment could recover anatomical relation of the lower tibia and fibula and ankle mortise, and obtain satisfying clinical effect.


Subject(s)
Adult , Ankle Fractures , Female , Fibula , Fracture Fixation, Internal , Fractures, Bone , Humans , Male , Middle Aged , Tibia , Treatment Outcome
7.
Article in Chinese | WPRIM | ID: wpr-871417

ABSTRACT

Objective:To design magnets to locate colorectal neoplasms based on magnetic tracer technology, and to test its feasibility and safety by animal experiments.Methods:The magnets used for endoscopic localization of colorectal tumors consist of a tracer magnet and a pursuit magnet, both of which are ring-shaped Nd-Fe-B magnets. Eight healthy Beagle dogs were used as animal models. Tumor locations were assumed in the different parts of the colon and rectum under colonoscopy. The tracer magnet was sent to the hypothetical tumors by endoscopic soft tissue clamp and fixed near the tumors. After 24 hours, laparoscopic surgery was performed under general anesthesia. The pursuit magnet was inserted near the resected colon or rectum through the main operating hole. The tracer magnet was absorbed to the pursuit magnet to identify the location of tumors.Results:The tracer magnet and pursuit magnet were successfully designed and processed. The suction force between the tracer magnet and the pursuit magnet at zero distance was 16 N. All the 8 Beagle dogs successfully received indwelling of magnets under colonoscopy, and no magnets fell off after 24 hours. After the placement of pursuit magnet under laparoscopy, the two magnets attracted each other rapidly and accurately, and successfully completed localization of tumor site without any damage during the operation.Conclusion:Colonoscopy combined with laparoscopy for colorectal neoplasms localization based on magnetic tracer technique is simple, accurate, safe and feasible.

8.
Article in Chinese | WPRIM | ID: wpr-870414

ABSTRACT

Objective To verify the feasibility and safety of stomach tumor marker localization based on magnetic tracer technique in dogs.Methods Six male Beagle dogs were examined by gastroscopy.Then tracer magnets were sent to the "tumor" locations assumed in advance and fixed near the "tumors" by endoscopic soft tissue clamp.Laparoscopic gastric tumor localization was performed under general anesthesia 24 hours later.The tracer magnet was placed near the tumor on the surface of the stomach through the operating hole after the conventional establishment of laparoscope puncture parallel mirror to explore the tracer magnet.After the two magnets were attracted,the location of the tracer magnet seen under the laparoscope was the location of the gastric tumor,so as to complete the labeling and positioning of the lesion.Results All the 6 Beagle dogs were successfully implanted with tracer magnets under gastroscopy.Twenty-four hours after the gastroscopy,the pursuit magnet was successfully implanted during laparoscopic surgery.The two magnets automatically attracted each other and formed a sandwich structure of "tracer magnet-gastric wall-pursuit magnet ",which completed the location and identification of gastric tumor under the laparoscopy.Conclusion Gastroscopy combined with laparoscopy based on magnetic tracer technique is simple,accurate,safe and feasible.

9.
Article in Chinese | WPRIM | ID: wpr-776102

ABSTRACT

OBJECTIVE@#To explore the clinical effect of conservative treatment for giant lumbar intervertebral disc herniation and analyze the factors affecting its resorption.@*METHODS@#From January 2013 to December 2016, the clinical data of 130 patients with giant lumbar intervertebral disc herniation were collected. The patients were classified according to the characteristics of Iwabuchi displacement and "bull eye sign", Xiaosui Huahe decoction of traditional Chinese medicine conservative treatment was used in the patients. There were 93 males and 37 females, aged from 15 to 64 years old with an average of(37.11±13.96) years old; with the disease duration ranging from 1 day to 8 years with an average of(11.82±20.45) months. Rate of intervertebral disc herniation was measured by Futian's method, and clinical effect was evaluated by JOA score.@*RESULTS@#All the patients were followed up from 13 to 48 months with an average of(21.45±11.87) months, and there were no significant differences in follow-up time between different imaging types(>0.05). The absorption rate 95 patients with persistent conservative treatment was(44.08±35.70)%. The absorption rate of Iwabuchi displacement positive group and "bull eye sign" positive group was significantly higher than the average value(<0.05). The rate of excellent and good JOA scores in 95 patients was 78.95%, 81.05% and 78.95% at 3, 6 and 12 months after treatment, respectively(<0.05). Finally 35 patients accepted surgical treatment, the rate of excellent and good JOA scores was 100% at 3, 6, 12 months after treatment(<0.05).@*CONCLUSIONS@#The clinical effect of Xiaosui Huahe decoction conservative treatment is satisfactory for giant lumbar intervertebral disc herniation. Patients with Iwabuchi displacement and "bull's eye sign" had significant herniation resorption.


Subject(s)
Adolescent , Adult , Aged , Female , Humans , Intervertebral Disc , Intervertebral Disc Degeneration , Intervertebral Disc Displacement , Lumbar Vertebrae , Male , Medicine, Chinese Traditional , Middle Aged , Treatment Outcome , Young Adult
10.
Article in Chinese | WPRIM | ID: wpr-746190

ABSTRACT

Objective To investigate the time relationship of the change,and diagnostic accuracy and sensitivity between retinal light threshold fluctuations (LTF) and retinal nerve fiber layer (RNFL) and ganglion cell complex(GCC) thickness on high-risk primary open-angle glaucoma (POAG).Methods Totally 319 patients (319 eyes) with high-risk in POAG from the First Affiliated Hospital of Kunming Medical Universityand during December 2009 and December 2017,50 healthy individuals (50 eyes) as control were collected in this longitudinal cohort study.Visual field and OCT were reviewed every 6 months on the high-risk group and every 12 months on the control group.High-risk groups inclusion criteria:vertical C/D≥0.6;early visual field defect (according to glaucoma visual field damage GSS2 quantitative grading standards,mean deviation and pattern standard deviation of central field exceeds the border as an early visual field defect);continuous repeatable results.The first field and OCT results in the absence of visual field defects and C/D≥0.6,which were conformed reliability indicators and removed learning effects as a baseline.When patients achieve POAG diagnosis criteria first time which was recorded as a turning point.And they were divided into early group meanwhile were ended of follow-up.After the last follow-up,the inspection data was segmented counted in yearly interval.The changes of LTF,thickness of RNFL and GCC during the follow-up period in the early POAG group and the control group were observed.The loss rate and change rate in each period were compared for the assessment of their trends with time.Followed by calculation of the area under receiver operating curves (AUC) to compare the predicted value of POAG and the sensitivity at 95% specificity in each period.Results After last follow-up,totally 67 patients 67 eyes (early POAG group,37 males and 30 females) were entered the turning point.The mean follow-up of the early POAG group and the control group were 6.6 and 6.4 years.The average RNFL thickness was 79.05± 8.09 μm,GCC thickness was 71.58 ± 8.41 μm,LTF was -6.05 ± 7.02 dB in early POAG group.The average RNFL thickness was 93.49± 6.24 μrm,GCC thickness was 79.72± 6.32 μm,LTF was-0.31 ± 0.58 dB in the control group.The differences of LTF and the thickness of RNFL and GCC were statistically significant (t=-5.97,-10.42,-5.60;P<0.001).The AUC of RNFL,GCC thickness and LTF increased with time in the early POAG group.The sensitivity was gradually increased at 95% specificity:5th year before to at turning point,RNFL thickness AUC was 0.15,0.65,0.71,0.77,0.85,0.92,and sensitivity was 20%,56%,61%,65%,70%,76%,respectively;GCC thickness AUC was 0.12,0.53,0.69,0.74,0.82,0.90,and sensitivity was 14%,53%,69%,74%,82%,90%,respectively;the AUC of LTF was 0.10,0.21,0.33,0.75,0.86,0.91,and sensitivity was 7%,17%,44%,65%,78%,87%,respectively.Conclusions The earliest time of structural functional damage of POAG is at the 4th year before confirmed,simultaneous RNFL diagnosis accuracy and sensitivity are better than GCC and LTF.The earliest time of visual functional damage of POAG is at the 2th year before confirmed,simultaneous LTF diagnosis accuracy and sensitivity are better than RNFL and GCC.

11.
Article in Chinese | WPRIM | ID: wpr-701576

ABSTRACT

Objective To explore the value of class 100 laminar flow ward in the prevention of infection in patients with hematological malignancies(HM) after chemotherapy.Methods Patients with HM and received chemotherapy in the department of hematology in a hospital from March 2016 to February 2017 were surveyed retrospectively,according to patients' wishes,those who were admitted to the class 100 laminar flow ward and received chemotherapy were as trial group,and those who were admitted to the common ward and received chemotherapy were as control group.The incidence of infection,duration of fever,antimicrobial use time,length of hospital stay,and index of infection were compared and analyzed between two groups.Results A total of 267 patients with HM received chemotherapy,74 cases in trial group and 193 in control group.During the chemotherapy period,incidence of infection in trial group was lower than that of control group (47.3% vs 72.0%,P<0.001).Respiratory tract,digestive tract,and urinary tract were main infection sites in both groups.A total of 45 strains of pathogens were isolated from two groups of patients,7 strains were isolated from trial group and 38 from control group.The isolated pathogens were Escherichia coli,Klebsiella pneumoniae,Stenotrophomonas maltophilia,Pseudomonas aeruginosa,and yeast.Duration of fever,antimicrobial use time,and length of hospital stay in trial group were all lower than control group (all P<0.05);serum procalcitonin (PCT) and C-reactive protein (CRP) levels in trial group were both lower than control group(both P<0.01),the time for PCT and CRP to return to normal in trial group were both lower than control group(both P<0.05).Conclusion Patients with MH and receive chemotherapy in class 100 laminar flow ward can reduce the incidence of infection,shorten the length of stay,and reduce the economic burden,it is worthy of further clinical promotion.

12.
Article in Chinese | WPRIM | ID: wpr-665222

ABSTRACT

Objective To analyze the main factors influencing the consumers' perceived value of TCM traceability system. Methods Based on the existing literature, this study constructed the analysis model of consumer perceived value influencing factors, and used the data of 370 consumers and Logistic regression analysis for study. Results Consumers' cognitive value and perceived value of TCM traceability system were lower, and consumers' perceived value of TCM traceability system was affected by sex, income, consumption habit, cognition degree of TCM, and quality evaluation level. Conclusion The government should formulate policies for the characteristics of different consumers, strengthen publicity, popularize the knowledge of TCM traceability system, and promote the construction and development of TCM traceability system, so as to ensure the quality and safety of TCM.

13.
Article in Chinese | WPRIM | ID: wpr-712278

ABSTRACT

Objective Aimed to develop the evaluation system and weight of hospital orientation training.Methods Literature review,Delphi,questionnaire,AHP to develop the evaluation system and determined the weight with Satty's method.Results The evaluation system includes 3 division's 13 items.Conclusions Course content,teaching method,course difficultness and occupational plan ning play the most important role,and should be paid more attention.

14.
Article in Chinese | WPRIM | ID: wpr-689951

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the outcome predictive factors of ruptured lumbar disc herniation after conservative treatment.</p><p><b>METHODS</b>From June 2009 to June 2016, 147 patients with ruptured lumbar intervertebral disc herniation were treated with conservative treatment in the orthopedics department of Suzhou Traditional Chinese Medicine Hospital for clinical efficacy and MRI follow-up. Multivariate Logistic regression analysis(Stepwise regression method)was used to analyze the relationship between the 11 categorical variables and absorptivity of protrusions: sex(X1), age(X2), course of disease(X3) , the rate of protrusion(X4), the Komori type(X5), the MSU type(X6), the Iwabuchi type(X7), the Pfirrmann grade(X8), the Modic change on adjacent vertebrae(X9), spinal canal morphology(X10), the Schizas types of cauda equina sedimentation sign(X11).</p><p><b>RESULTS</b>A total of 64 cases of prominent reabsorption among all cases followed-up (absorption rate>=30%), accounting for 43.5%. The reabsorption of protrusions is more likely to occur in patients with a duration of less than 1 year(0.006), MSU type 3 (0.001), Iwabuchi type 1 or 5 (0.000), the Schizas type of cauda equina sedimentation sign A or B(0.004). Regression equation Y=-10.363+1.916X3+1.446X4-1.445X5+2.070X6+4.679X7+1.125X9+1.023X10+2.223X11. Such factors as age, gender, Pfirrmann classification and spinal canal morphology had no significant effect on reabsorption of protrusions.</p><p><b>CONCLUSIONS</b>Ruptured lumbar disc herniation can be reabsorbed after nonoperative treatment. And the reabsorption of protrusions is more likely to occur in patients with a duration of less than 1 year, MSU type 3, Iwabuchi type 1 or 5, the Schizas type of cauda equina sedimentation sign A or B, which can be used as the key reference factors for predicting the outcome of the projections.</p>

15.
National Journal of Andrology ; (12): 337-342, 2017.
Article in Chinese | WPRIM | ID: wpr-812763

ABSTRACT

Objective@#To compare three different pathways for transurethral seminal vesiculoscopy (SVS) and investigate the reliability and efficiency of transrectal ultrasonography (TRUS)-guided SVS (TRUS-SVS).@*METHODS@#We retrospectively analyzed 90 cases of seminal vesiculoscopy conducted directly through the ejaculatory duct or prostatic utricle or under the guide of TRUS. We compared the success rate and complications among the three approaches.@*RESULTS@#Operations were successfully performed in 87 (96.67%) of the 90 cases, 30 through the ejaculatory duct, 37 via the prostatic utricle, and 20 under the guide of TRUS, the operation time ranging from 25 to 75 minutes. Sperm was detected from the seminal vesicle fluid in (92.06%) of the azoospermia patients (58/63) during the surgery and in 77.78% of them (49/63) in semen analysis at 1 week postoperatively. Fifteen hematospermia and 12 spermatocystitis patients were cured. Postoperative follow-up found 20 cases of water-like semen and 3 cases of orchiepididymitis, but no such complications as retrograde ejaculation, incontinence, or rectourethral fistula.@*CONCLUSIONS@#Transejaculatory duct and transprostatic utricle pathways are two common approaches to SVS, while TRUS-SVS may achieve a higher success rate and avoid injury of both the prostate and the rectum.


Subject(s)
Azoospermia , Diagnostic Imaging , Ejaculatory Ducts , Diagnostic Imaging , Epididymitis , Diagnostic Imaging , Genital Diseases, Male , Hemospermia , Diagnostic Imaging , Humans , Male , Operative Time , Prostate , Diagnostic Imaging , Rectum , Reproducibility of Results , Retrospective Studies , Semen , Semen Analysis , Seminal Vesicles , Diagnostic Imaging , Spermatozoa , Ultrasonography , Methods
16.
Article in Chinese | WPRIM | ID: wpr-508079

ABSTRACT

Digitalization of ancient medical documents has become an important platform for the development and protection of medical literature and digitalization of ancient medical documents based on ancient medical documents themselves will lead to a series of intellectual property rights. After the relationship between ancient medical docu-ments and protection of intellectual property rights was analyzed, the major intellectual property rights involved in current digitalization of ancient medical documents were pointed out with their solutions elaborated from the reasona-bleness, rationality, legality and normality.

17.
Article in Chinese | WPRIM | ID: wpr-641167

ABSTRACT

Objective To assess the diagnostic value of contrast enhanced ultrasound (CEUS),elastography and their combined use in diagnosing thyroid nodules of thyroid imaging reporting and data system (TI-RADS) 4. Methods From November 2011 to August 2016, 159 TI-RADS 4 nodules diagnosed by conventional ultrasound were prospectively enrolled and examined by CEUS and elastography before surgery. Multivariate logistic regression models were established for CEUS and CEUS combined with elastography to diagnose thyroid malignancy. The diagnostic performances of CEUS, elastography and their combined use were evaluated with the receiver operating characteristic (ROC) curve. The sensitivity,specificity, accuracy, positive predictive value, negative predictive value and omission diagnostic rate of CEUS, elastography and their combined use were compared by Chi-square test. Results The CEUS features significantly predicting malignancy were heterogeneous enhancement, hypoenhancement, without or incomplete ring-enhancement and later time to peak than the surrounding parenchyma (χ2=24.378, 69.194,29.434 and 7.375, all P 0.05). Conclusion The diagnostic value of CEUS combined with elastography was remarkably significant in the differential diagnosis of TI-RADS 4 nodules.

18.
Article in Chinese | WPRIM | ID: wpr-641129

ABSTRACT

Objective To evaluate the diagnostic value of gray-scale ultrasonography (GSU) combined with contrast-enhanced ultrasonography (CEUS) and real-time elastography imaging (EI) in solid thyroid nodules.Methods A total of 124 solid nodules were collected from Xuanwu Hospital of Capital Medical University from September 2011 to November 2014, including 49 benign nodules and 75 malignant nodules conifrmed by surgical pathology. The data of multimodal imaging were retrospectively analyzed and compared with the pathological results. The parameters among the groups were compared byχ2 test. Four diagnostic models including the statistically signiifcant independent variables were established accord to different combinations of routine ultrasound examination. The binary Logistic regression equation using the pathological results as the dependent variable Y and the ultrasound features of thyroid nodules as independent variableX was established for calculating the area under the receiver operator curve (ROC) and multiple regression analysis furthermore.Results There were statistically significant differences in aspect ratio, margin condition, echo type, CEUS features, elastic imaging score and elastic strain rate of benign and malignant thyroid nodules(χ2=13.966, 7.106, 24.215, 17.250 and 27.158,P<0.05).The four Logistic regression models were statistically signiifcant (χ2=5.37, 5.37, 8.155, 8.155, allP<0.05). By using modelⅠ,Ⅱ,Ⅲ andⅣ, the diagnostic sensitivity, speciifcity and accuracy of malignant nodules were (73.8%, 75.9%, 79.7%, 83.3%), (67.5%, 70.7%, 85.2%, 86.7%), and (71.8%, 74.2% 81.8%, 84.4%) respectively. The area under the ROC of logistic equation predicted values were (0.778, 0.809, 0.875 and 0.898, allP<0.01). Multivariate categorical analysis showed that aspect ratio, margin condition and the elastic strain rate ratio (χ2=13.73, 7.541 and 11.461, allP<0.05) of thyroid nodules were effective diagnostic indicators. Conclusions Our study indicated that CEUS and EI could be helpful modality for GSU to improve the diagnostic accuracy of thyroid nodules. The combined application of multi mode ultrasound examination has a high diagnostic value.

19.
Article in Chinese | WPRIM | ID: wpr-230391

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the preliminary curative effect of arthroscopic reduction and utilization of Suture Bridge tech reconstructing footprint area structure for anterior cruciate ligament avulsion fracture.</p><p><b>METHODS</b>From March 2010 to September 2012, 6 patients suffered anterior cruciate ligament avulsion fracture were treated with arthroscopic Suture bridge fixation for anterior cruciate ligament tibial side footprint reconstruction. There were 2 males and 4 females, ranging in age from 14 to 52 years old. There were 2 cases of type III and 4 cases of type IV displaced fractures classified by Meyers-McKeever-Zaricznyj. Preoperative ADT and Lachman tests were positive.</p><p><b>RESULTS</b>All the patients was follow up more than 2 years. Postoperative ADT and Lachman tests were negative without limitation of knee extension. Postoperative X ray and MRI showed that displaced fracture with a good reduction and union, recovered normal shapeness of ACL. The postoperative Lysholm and IKDC scores at different time points(3 months, 1 year, 2 years after operation) improved significantly comparing with preoperative, and the differences were statistically significant (<0.01).</p><p><b>CONCLUSIONS</b>Suture Bridge tech reconstructing footprint area structure for ACL avulsion fracture is an effective and safe method, especially for adolescent patients with unclosed epiphysis and comminuted avulsion fracture.</p>

20.
Article in Chinese | WPRIM | ID: wpr-230351

ABSTRACT

<p><b>OBJECTIVE</b>To observe the clinical result and healing of meniscal suture under arthroscopy for the treatment of the middle aged patients with meniscal injury.</p><p><b>METHODS</b>From March 2014 to January 2015, 40 middle-aged patients included in the standard with injury of meniscus, which were repaired by meniscal suture technique under arthroscopy, involving 24 males and 16 females with an average age of (52.65±3.63) years ranging from 50 to 60 years; 28 cases were on left knee, 12 cases were on right knee. Average flexion angle averaged (117.50±7.16) ° ranging from 110° to 130°. Lysholm knee score averaged 54.30±14.72 ranging from 23 to 71; IKDC score averaged 50.65±15.95 ranging from 18 to 78; the WOMAC score averaged 23.80±19.39 ranging from 2 to 75. All-inside meniscus suture under arthroscopy was performed.</p><p><b>RESULTS</b>All operations were successful without serious complications. Postoperative follow-up was 6 to 12 months, none of the patients lost to follow-up. All patients maintain a category 5 degree muscle strength, normal knee joint mobility, can completely straight and completely buckling. Average flexion angle was (125.00±5.13) ° (110° to 130°) (=3.47,=0.003). Final Lysholm scale, IKDC scores and WOMAC scores averaged 79.50±8.70 (=7.790,=0.000), 79.40±10.40 (=8.431,=0.000), 8.15±6.77 (=3.988,=0.001) separately. Follow-up MRI showed that meniscus healed in 4 cases, partially healed in 22 cases, haven't healed in 14 cases. Failure rate of small lesion was 27.3%(6/22), and failure rate of large lesion was 44.4%(8/18).</p><p><b>CONCLUSIONS</b>Clinical effect of meniscal suture under arthroscopy for the treatment of the middle aged is good. The failing rate was 35% because of healing ability is poor in middle-aged adults. Failure rate of large lesion was higher than that of small lesion.</p>

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