[A case-control study on the relations between insulin resistance and essential hypertension in YI NATIONALITY living in Liangshan, Sichuang Province].

OBJECTIVE: To determine whether insulin resistance (IR) was associated with essential hypertension (EH) in YI nationality living in Liangshan, Sichuang Province. METHODS: A case-control study consisting of 113 YI hypertensives as cases and 156 YI normotensives as controls were conducted to investigate the level of fasting glucose (FG) and fasting insulin (FINS), and insulin resistance index was used as the indicator of IR. RESULTS: It was found that impaired fasting glucose (IFG) and IR were associated with EH significantly among YI migrants, and OR (95% CI) were 3.98 (2.14 approximately 7.42, P < 0.001) and 2.55 (1.35 approximately 4.83, P = 0.004) respectively. Being stratified by sex, both IFG and IR were associated with EH significantly among YI male migrant, and OR were 4.31 (2.01 approximately 9.24, P < 0.001) and 3.14 (1.45 approximately 6.82, P = 0.003) respectively; but only IFG was associated with EH significantly among YI female migrant and OR was 3.46 (1.17 approximately 10.22, P = 0.022). Among YI farmers, both IFG and IR were not associated with EH significantly. The non-conditional logistic regression analysis showed that IR was associated significantly with EH among YI migrants. This was not as same as observed in YI farmers. CONCLUSION: It is likely that IR is the risk factor of EH among YI migrants in our study. However, the association between IR and EH among YI farmers needs some further studies.

The efficacy analysis of selective decompression of lumbar root canal of elderly lumbar spinal stenosis / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of the treatments of lumbar spinal stenosis by selective decompression of lumbar root canal and laminectomy.</p><p><b>METHODS</b>From March 2007 to March 2011, 144 lumbar spinal stenosis patients were treated by selective decompression of lumbosacral root canal and laminectomy. All of these patients included 64 male and 80 female patients, age range 60-87 years, average (66 ± 5) years. Duration 6-72 months, average (12 ± 16) months. The patients were divided into 2 groups according to surgical procedure underwent: group A including 70 patients who were treated with selective decompression of lumbar root canal, group B including 74 patients who were treated with traditional laminectomy. Five time points were selected to assess clinical effect using Oswestry disability index (ODI) and Japanese Orthopaedic Association (JOA), which were pre-operation and 1 month, 6 months, 12 months and last follow-up. The data were analyzed through Wilcoxon matched-pairs signed-ranks test.</p><p><b>RESULTS</b>All operations were completed well without severe complications. The duration of follow-up was 12-55 months, average (31 ± 6) months. All patients' symptoms got improved or partial remission. The average pre- and post-operative scores of JOA in group A and B were from 14.0 ± 1.6 to 20.3 ± 1.7, from 13.6 ± 1.7 to 20.2 ± 2.0, respectively, there were significant statistical differences (Z = 2.41 and 2.23, P < 0.05). The average pre- and post-operative scores of ODI in group A and B were from 62% ± 4% to 28% ± 4%, from 63% ± 4% to 27% ± 3%, respectively, there were significant statistical differences (Z = 2.93 and 2.64, P < 0.05).</p><p><b>CONCLUSIONS</b>Personalized treatment programs should be established for elderly lumbar spinal stenosis according to stenosis location. Laminectomy is carried out with the stenosis in the central spinal canal; selective decompression of lumbosacral root canal is accepted with the stenosis in the nerve root canal without central stenosis.</p>