RESUMO
PURPOSE: To explore the epidemiological trends in acetabular fracture and report the mid-term to long-term clinical outcomes of the elderly treated with operation. METHODS: Retrospective study. Patients aged ≥ 14 years with operative treatment of the Acetabular fracture from Jan 2010 to Dec 2019 at a level-1 trauma centre were identified to analyze the epidemiological trends, and the difference in fracture patterns between young and elderly patients (≥ 60 years old) were compared. The elderly patients were followed up to evaluate their clinical outcomes and satisfaction degree (worst to best: 0 to10). The patients were divided into the 2010-2014 group and the 2015-2019 group according to the year of admission, and the clinical outcomes of the two groups were compared to verify the stability from mid-term to long-term after surgery for acetabular fracture. RESULTS: A total of 1024 patients (mean age 43.35 years, range 14-86 years) with acetabular fractures received operative treatment in this decade. The mean age of the acetabular fracture patients increased from 41.1 years to 47.7 years, and the proportion of elderly patients increased from 5.7% to 24.0%, with some volatility. The ratio of male to female decreased year by year, and the proportion of female patients increased with age. And the anterior fracture patterns were more common in the elderly patients compared to the young patients (P < 0.001). 118 elderly patients (82 males, 36 females; mean age 66.91 years, range 60-86 years) were followed-up (mean 77.4 months, range 35-152 months). The overall mortality rate of the elderly patients was 7.69% (9/118). The Harris hip score of those alive patients was 90.41 ± 12.91 points (excellent and good rate 84.4%). 87 patients completed the SF-12 with a normal HRQoL (PCS 50.49 ± 8.88 points; MCS 55.66 ± 8.86 points). 90.8% of the patients achieved a satisfaction score of 9 or higher. And there was no significant difference in clinical outcomes between the 2010-2014 group and the 2015-2019 group (P > 0.05). CONCLUSIONS: In conclusion, acetabular fractures presented an obvious ageing trend in China, and the fracture patterns of the elderly patients differed from those in the young patients. Operative treatment for elderly acetabular fractures yielded satisfactory and persistent clinical outcomes from mid-term to long-term clinical.
Assuntos
Fraturas Ósseas , Fraturas do Quadril , Fraturas da Coluna Vertebral , Idoso , Humanos , Masculino , Feminino , Adulto , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Pré-Escolar , Criança , Estudos Retrospectivos , Resultado do Tratamento , Acetábulo/cirurgia , Acetábulo/lesões , Fraturas do Quadril/epidemiologia , Fraturas do Quadril/cirurgia , Fraturas Ósseas/epidemiologia , Fraturas Ósseas/cirurgia , Fixação Interna de Fraturas , China/epidemiologiaRESUMO
Objective:To evaluate the effect of the impaction of posterior wall on the prognosis following open reduction and internal fixation for fractures of acetabular posterior wall.Methods:A retrospective study was conducted to analyze the data from the 83 patients with fracture of acetabular posterior wall who had been consecutively treated by open reduction and internal fixation at Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital from January 2017 to December 2020. The patients were divided into 2 groups based on involvement of posterior wall impaction. In the impaction group of 33 cases, there were 26 males and 7 females with an age of (47.4±11.6) years; in the non-impaction group of 50 cases, there were 43 males and 7 females with an age of (41.3±12.0) years. The quality of postoperative fracture reduction, the function of the affected hip at the last follow-up, and the complication rate during follow-up were compared between the 2 groups. Multifactorial binary logistic regression and age subgroups were used to analyze the effects of posterior wall impaction on functional outcomes.Results:The age, rate of associated injuries in other body parts, and rate of posterior wall comminution in the impaction group were significantly higher than those in the non-impaction group ( P<0.05), but there was no statistically significant difference in other general data of patients between the 2 groups ( P>0.05). All patients were followed up for (44.5±13.3) months after surgery. The rate of anatomical reduction in the non-impaction group (96.0%, 48/50) was significantly higher than that in the impaction group (57.6%, 19/33) ( P<0.05), and the good and excellent rate by the modified Merle d'Aubigné & Postel scale at the last follow-up in the non-impaction group (84.0%, 42/50) was significantly higher than that in the impaction group (51.5%, 17/33) ( P<0.05). There was no significant difference in the incidence of complications between the 2 groups ( P>0.05). After adjusting for age and gender, the difference in hip function was still significantly different between the 2 groups ( OR=0.23, 95% CI: 0.06 to 0.79, P=0.020). The effect of posterior wall impaction on functional outcomes was statistically significant in patients aged ≥50 years ( P=0.008), whereas the difference was not statistically significant in patients aged <50 years ( P=0.194). Conclusions:Compared with non-impaction ones, acetabular fractures of posterior wall impaction tend to lead to poorer quality of reduction, which in turn affects the postoperative recovery of hip joint function. The impact of impaction fractures on functional recovery is more significant in patients aged 50 years and above.
RESUMO
Objective:To compare the long-term clinical outcomes between cannulated screw internal fixation for stable femoral neck fractures and arthroplasty for unstable ones in the elderly patients.Methods:A retrospective study was conducted to analyze the 542 patients with femoral neck fracture who had been admitted to Department of Orthopedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical University from May 2015 to April 2017. The 542 patients were divided into 2 groups based on fracture stability and treatment method. In the stable group (Garden type Ⅰ, type Ⅱ, and abduction compression type) of 121 cases who underwent cannulated screw internal fixation, there were 28 males and 93 females with a mean age of (77.6±8.1) years, and 20 cases of type Ⅰ, 101 cases of type Ⅱ, and 34 cases of abduction compression type by the Garden classification. In the unstable group (Garden type Ⅲ, type Ⅳ, and type Ⅱ with a posterior tilt angle >20°) of 421 cases who underwent arthroplasty, there were 130 males and 291 females with a mean age of (78.7 ± 6.9) years, and 14 cases of type Ⅱ, 403 cases of type Ⅲ, and 4 cases of type Ⅳ by the Garden classification. The postoperative mortality, reoperation rate, and mobility at the last follow-up were compared between the 2 groups.Results:There were no statistically significant differences in the baseline characteristics, except for serum albumin concentration and peripheral white blood cell count at admission, between the 2 groups, indicating comparability ( P>0.05). The hospital stay in the stable group [5.0 (4.0, 6.0)d] was significantly shorter than that in the unstable group [6.0 (5.0, 8.0)d], and the follow-up time for the stable group [54.4 (49.3, 58.7) months] significantly longer than that for the unstable group [52.2 (46.0, 59.3) months] ( P<0.05). A total of 158 patients (45 cases in the stable group and 113 cases in the unstable group) were lost to the last follow-up. At the last follow-up, the mortality in the stable group (18.4%, 14/76) was significantly lower than that in the unstable group (31.5%, 97/308), the reoperation rate in the former (15.8%, 12/76) significantly higher than that in the latter (3.6%, 11/308), and the capability of daily activities in the former (by the fracture mobility scoring: level 1 in 35 cases, level 2 in 13 cases, level 3 in 3 cases, level 4 in 2 cases, and level 5 in 1 case) significantly better than that in the latter (level 1 in 99 cases, level 2 in 47 cases, level 3 in 24 cases, level 4 in 22 cases, and level 5 in 5 cases) (all P<0.05). Conclusion:Compared with the arthroplasty for unstable femoral neck fractures, cannulated screw internal fixation for stable femoral neck fractures leads to a lower long-term mortality and a better capability of daily activities, but a significantly higher reoperation rate.
RESUMO
Objective:To elucidate the recent therapeutic efficacy of the intelligent fracture reduction robotic system in managing pelvic fractures.Methods:A retrospective evaluation of 49 pelvic fracture patients treated using the intelligent fracture reduction robotic system at Beijing Jishuitan Hospital's trauma orthopedics department between March 2021 and December 2022 was conducted. The cohort included 30 males and 19 females, with a mean age of 51.51±18.71 years (20-92 years range). Fractures were classified according to the Tile system: B1 type in 2 cases, B2 in 7, B3 in 3, C1 in 30, and C2 in 3. The median interval between injury and surgery was 6 days, with a range of 2-22 days. The robotic system assisted in pelvic fracture reduction and stabilization surgeries. Preoperative and postoperative evaluations involved pelvic CT scans, anteroposterior, inlet, and outlet radiographic images. Fracture displacement and reduction outcomes were assessed via X-ray imagery. Data captured included intraoperative blood loss, duration of surgery, fracture stabilization techniques, and postoperative monitoring period. The Majeed scoring system gauged functional outcomes.Results:Of the patients, 48 underwent minimally invasive interventions with robotic assistance, while one case necessitated open reduction and internal fixation due to an unsuccessful reduction. The duration between injury and operation ranged from 2 to 22 days. Average surgical time stood at 206.5±7.1 minutes (105-440 min range), and median intraoperative blood loss was 100ml (10-600 ml range). Using the Matta reduction criteria, 30 postoperative cases exhibited excellent and 9 good outcomes for posterior pelvic ring displacement, translating to a 93% (38/41) positive rate. For anterior pelvic ring shifts, 45 showed excellent and 3 good outcomes, culminating in a 100% (48/48) success rate. Follow-up for the 48 cases lasted 11.0 months (3-23 months range), with the Majeed functional score averaging 81.9±17.0 points (42-100 point range). 27 cases scored excellent, and 11 good, yielding a combined positive outcome rate of 79.2% (38/48).Conclusion:Employing the intelligent fracture reduction robotic system in pelvic fracture treatments facilitates minimally invasive interventions and yields favorable short-term clinical results.
RESUMO
Status epilepticus is a neurological emergency with unknown pathogenesis, controversial treatment options, and poor prognosis. In recent years, with the development of 18F-flurodeoxyglucose positron emission tomography ( 18F-FDG PET) imaging technology, further studies on status epilepticus have been carried out from the perspective of molecular metabolism. This article reviews the current role of 18F-FDG PET in patients with status epilepticus on etiology, disease activity, electric activity, location of epileptogenic foci, and prognosis evaluation.
RESUMO
Background@#and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. @*Methods@#We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). @*Results@#There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. @*Conclusions@#During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.
RESUMO
@#Objective To study the role of ubiquitin proteasome pathway in Du Meridian moxibustion for skeletal muscle aging. Methods A total of 30 Sprague-Dawley rats were randomly separated into control group (n=10), model group (n=10) and moxibustion group (n=10). The model group and the moxibustion group were subcutaneously injected D-galactose 125 mg/kg daily for six weeks, while the control group was injected the same volume of saline. Then the moxibustion group was cauterized on Du Meridian 20 minutes a day for 20 days. The expression of ubiquitin, muscle RING finger 1 (MuRF1) and muscle atrophy F-box (MAFbx) in erector spinae were tested with Western blotting. Results The expression of ubiquitin, MuRF1 and MAFbx increased in the model group compared with that of the control group (P<0.05), decreased in the moxibustion group compared with that of the model group (P<0.05).Conclusion The Du Meridian moxibustion may regulate ubiquitin proteasome pathway to inhibit the degradation of protein, and delay muscular atrophy.
RESUMO
Objective To explore integrated teaching based on small private online course (SPOC) in lymphoma clinical courses for medical undergraduates.Methods A total of 60 medical undergraduates in the department of hematology were randomly allocated to SPOC teaching group (n=30) and problem-based learning (PBL) teaching group (n=30) according to scores of the basic medical theoretical examination for lymphoma clinical courses education.After teaching activities,personal experiences were evaluated by anonymous questionnaires from medical undergraduates and instructors.Besides teaching efficacies assessed by objectively measurable score system including academic examination scores,clinical skill and capabilities in analyzing clinical problems of students,were systematically analyzed and compared between two groups by SPSS 19.0.Results The survey results showed that compared with PBL teaching group,SPOC teaching group had higher teaching feedback evaluation and better teaching experience,and SPOC were widely recognized by teachers and students.The SPOC teaching group's scores of the three items in the exam were better than those of the PBL teaching group,with the academic achievement [(84.03 ± 7.66) vs.(77.60 ± 8.22),P=0.005],the performance of practical skills [(87.83 ± 8.17) vs.(81.97 ± 6.13),P=0.001],and case analysis results [(88.17 ± 6.53) vs.(80.10 ± 6.91),P=0.000],and the difference was statistically significant.Conclusion Integrated teaching based on SPOC is feasible for lymphoma clinical courses,which can trigger interest of students,enhance learning abilities and their clinical capabilities.Moreover,this novel medical education approach may provide new ideas and theoretical basis in training qualified and talent doctors.
RESUMO
OBJECTIVE To explore the condition of the cellular immune function of children with obstructive sleep apnea hypopnea syndrome(OSAHS) and its change after operation METHODS Eighty children diagnosed as OSAHS were included in this study. T lymphocyte subsets and NK cells of the blood were measured before operation and one month after operation respectively. Children without the related disorders or systemic disease were recruited as control group.RESULTS Before operation, CD4+T cell percentage, CD4+/CD8+ ratio and NK cell percentage in OSAHS children were significantly lower than that in the control group[(26.19±3.38)%vs (5.10±4.09)%, (0.90±0.19)%vs (1.61±0.52)%, (11.45±4.35)%vs (13.73±3.78)%,P0.05). CONCLUSION OSAHS may damage the cellular immune function. The operation does not reduce the cellular immune function in the short term.
RESUMO
Purpose] To detect respiratory virus antigen by direct immunofluorescence method and provide evidence for early diagnosis of children with viral infection of the respiratory tract disease.[Methods] Select 398 cases of respiratory tract infection in hospitalized children, pharynx in exfoliated cells in respiratory syncytial virus by direct immunofluorescence(RSV), adenovirus(ADV), influenza virus type A(IFVA),influenza virus type B(IFVB), parainfluenza virus type 1(PIV1), parainfluenza virus type 2(PIV2) and parainflue-Nza virus type 3(PIV3) of 7 common viral antigens were detected, and carried on statistics analysis.[Results] In 398 cases of children with respiratory tract infection, 91 cases were positive, the positive rate was 22.86%. The highest for respiratory syncytial virus in 37 cases(40.66%) followed by parainfluenza virus type 3 in 19 cases(20.88%), influenza virus type B in 14 cases(15.38%); The positive rates of acute tonsillitis, capillary bronchitis, pneumonia, acute bronchitis and upper respiratory were 46.67%(14/30),40.00%(20/50), 26.67%(40/150), 18.42%(7/38), 7.69%(10/130) respectively; With the growth of age, the respiratory tract virus infection rate gradually decreased(P<0.05), one year old the viral infection rate was 76.92%;it occurred in the winter season of respiratory tract infection in children .[Conclusion] The main virus in children with acute respiratory infection in the local area is RSV. Virus infection decreases with the increase of age, treatment should be careful in the use of antibiotics.
RESUMO
OBJECTIVE@#This study was to investigate the clinical symptoms, characterization of imaging technique and the effect of endonasal endoscopic surgery.@*METHOD@#Following 38 cases of isolated sphenoid sinus disease patients, among whom 35 cases treated with nasal sinus CT (including 5 cases of MRI at the same time), 3 cases undergoing sinus MRI, 1 cases going through the CT cisternography. All patients underwent endoscopic sphenoid otomy, of which 33 cases underwent nasal olfactory cleft approach, 5 cases anterior ethmoid sinus and posterior ethmoid sinus approach (Messerklinger technology).@*RESULT@#All patients were followed up for more than half a year, of which 34 were recoverd and 4 were improved. No obvious complications came up during or after endoscopic surgery.@*CONCLUSION@#Isolated sphenoid sinus disease clinical symptoms are not typicaland without specialty; nasal examination had no positive sign, only with headache as the chief neurological symptom, often difficult to diagnose at an early stage. The CT and MRI are the best methods for the diagnosis of isolated sphenoid sinusitis. The nasal endoscopic operation is the preferred method for treatment of this disease.
Assuntos
Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Endoscopia , Seguimentos , Doenças dos Seios Paranasais , Diagnóstico , Cirurgia Geral , Estudos Retrospectivos , Seio Esfenoidal , Resultado do TratamentoRESUMO
A three-dimensional (3D) transrectal ultrasound (TRUS) imaging system is presented in this paper. The 3D imaging system is used for diagnosing diseases of prostate. The 3D image is reconstructed by a series of two-dimensional image data which is obtained through rectum. It can be a guide to prostate needle biopsies. The system is built by two parts: hardware and software. In the hardware, the mechanical device, stepper motor, control circuit, B Mode TRUS and personal computer (PC) workshop are presented. The software includes the firmware of micro control unit and software of the PC workshop. In order to evaluate the performance of the 3D imaging system, we did experiments with water and agar phantoms, and the results demonstrated the system's ability of 3D imaging with high-precision.
Assuntos
Humanos , Masculino , Biópsia por Agulha , Imageamento Tridimensional , Imagens de Fantasmas , Próstata , Diagnóstico por Imagem , Reto , Software , UltrassonografiaRESUMO
Objective To study the correlation of operation timing,mode and curative effects of patients with severe hypertensive cerebral hemorrhage.Methods 90 patients with hypertensive cerebral hemorrhage were collected and divided into super early treatment group (32 cases),early treatment group (29 cases),delayed treatment group (29 cases) and big bone flap craniotomy treatment group (41 cases),small bone window craniotomy operation removal group(49 cases).The therapeutic effect,neural function and mental state were observed.Results The total effective rate (93.32%,93.56%),MMSE score [(22.22 ± 2.33) points,(31.55 ± 3.68) points] of super early group and small bone window craniotomy group were significantly higher than other groups (F =6.672,5.325,all P < 0.05.x2 =6.852,7.372,all P < 0.05),CSS score [(17.92 ± 1.84) points,(17.41 ± 1.97) points],NIHSS score [(22.22 ±2.33) points,(22.53 ± 2.48) points] were significantly lower than other groups(F =5.624,6.621,all P < 0.05.F =5.458,6.171,all P < 0.05).The operation timing was positively correlated with CSS and NIHSS score,while negatively correlated with MMSE.The operation mode was negatively correlated with CSS and NIHSS score,while positively correlated with MMSE.Conclusion Early small bone window craniotomy operation therapy has the positive clinical value,it can improve the treatment efficacy and neurological function.
RESUMO
10.3969/j.issn.1007-3969.2013.04.010
RESUMO
A new scanning mode is proposed that the front-end of the probe is fixed, while the back-end makes fan-shaped, scanning movement. The new scanning mode avoided ribs drawbacks successfully. Based on the new scanning mode a 3D-Ultrasound Images System is accomplished to acquire 2D data of fetusfetus fetusfetus phantom and livers and kidneys, to demonstrates the effectiveness of the new scanning mode.
Assuntos
Humanos , Feto , Imageamento Tridimensional , Rim , Fígado , Imagens de Fantasmas , Ultrassom , MétodosRESUMO
Objective To observe the clinical curative effect of chronic heart failure (CHF) treated by noninvasive positive pressure ventilation ( NPPV). Methods 48 cases of CHF were randomly assigned to conventional drug treatment under oxygen (control group, n = 24) and non-invasive positive pressure ventilation ( NPPV) under the conventional therapy group (observation group, n =24). The plasma N-brain natriuretic peptide( proN-BNP) and cardiac function changes in two groups before and after treatment were observed. Results The total effective rate 92% in observation group was significantly higher than 66% in control group ( x2 =3. 7851, P < 0. 05 ) ; The plasma proNBNP、respiratory rate and heart rate after treatment in two groups were lower than before treatment(t = 2.787,2.815, 2. 856,2.789,2.804,2.840,all P<0.01) ;The plasma proN-BNPand heart rate in observation group after treatment were lower than the control group(t =2.123,2.221,all P <0.05). Conclusion Noninvasive positive pressure ventilation could significantly improve heart function,reduce plasma proN-BNP and enharce curative effect.
RESUMO
Objective To evaluate the clinical efficacy and toxicity of EPOCH regimen in the treatment of elderly patients with peripheral T-cell lymphoma. Methods Twenty-eight elderly patients with pathologically diagnosed peripheral T-cell lymphoma were treated with EPOCH regimen, including 96-hour continuous infusion of etoposide 50 mg/m2, epirubincin 12 mg/m2 and vincristin 0.4 mg/m2 on daysl through 4,cyclophosphamide 750 mg/m2 given as intravenous bolus on day 5 and prednisone 60 mg/m2 administered orally on daysl through 5. The EPOCH regimen was repeated very 21 days. Clinical efficacy and safety profiles of EPOCH regimen was systemically reviewed and analysed. Results All the 28 patients received a total of 85 cycles of EPOCH regimen. The median cycles was two courses. Fifteen patients achieved complete response, while five cases obtaining partial response. The overall response rate was 71.4 %. The median survival time was 20 months. In newly diagnosed patients, complete response rate (CR) as well as partial response (PR) and overall response rate (OR) reached 64.7 %, 23.5 % and 88.2 %, respectively, which was significantly higher than that in refractory cases, whose CR, PR and OR were 36.4 %, 9.1% and 45.5 %(λ 2 = 5.99, P <0.05). In addition, the median survivalduration of newly diagnosed patients was longer than that of refractory cases, whose median survival time was 24 and 13 months, respectively. The major adverse events was myelosuppression with grade 3-4 neutropenia and thrombocytopenia in 53.6 % and 50.0 % cases.Non-hematologic toxicities were moderate and uncommon. The frequency of adverse effects in de novo patients showed little difference in comparison with that in refractory ones (P>0.05). Conclusion EPOCH regimen was an effective and well tolerated therapeutic schedule for elderly patients with peripheral T-cell lymphoma.
RESUMO
Objective To investigate a special optimization technique for computer aided measure, and provide anatomical basis for screw internal fixation in the cavitas glenoidalis through the coracoid process of scapula. Methods Thirty accurate scapula models were reconstructed from CT data sets. First, special optimization objective function was designed for single screw internal fixation configuration, and the optimal placement of screw was found automatically under constraints. Then, the placements of double screws internal fixation configuration were searched taking advantage of principal component analysis. Finally, statistical measure data were provided according to new anatomical reference landmarks for clinical use. Results For single screw internal fixation configuration, the distance from the optimal screw entry point P to the acromion process point X was (39.15±2.28) mm, to the coracoid process point Y was (28.66±2.68) mm, to the angulus superior point Z was (61.13±6.57) mm;The angle was (81.27±7.15)° between PX and PY, and (133.27±6.84)° between PX and PZ. The mean inclination of the lag screw was (104.08±4.41)° for the angle with line PX, (101.29±3.51)° with line PY, and (76.23±5.03)° with line PZ. For double screws configuration, the distance from the original single screw entry point P to the screw entry point E was (5.12±1.37)mm,to the screw entry point F was (3.88±0.94)mm. The angle between the long axis of coracoid process and line EF was (27.41±3.51)°. Conclusion The automatic optimization technique for computer aided measure is very efficient and has many advantages over the conventional manual dissection methods, and is convenient to design new anatomical reference landmark system for clinical use.
RESUMO
Objective To study the influence of BiPAP on lipid level in patients with chronic heart failure of coronary heart disease.Methods 20 patients with chronic heart failure of coronary heart disease were taken BiPAP:Blood samples were taken from forearm vein before and 4 weeks and 12 weeks after treatment,the lipid level was measured and compared.Results The observation group of The coronary heart disease with chronic heart failure in pre-treatment serum level of total cholesterol(TC)(7.47±0.12)mmol/L,triglycerides(TG)(3.52±0.13)mmol/L,low-density lipoprotein cholesterol(LDLc)(3.73 ±0.11)nmmol/L,apolipoprotein-B(Apo-B)(1.37±0.02)g/Lwere significantly lower than 14 weeks after treatment TC(4.5±0.03)mmol/L,TG(2.6±0.02)mmol/L,LDLc(2.8±0.06)mmol/L,Apo-B(1.02±0.02)g/L)(t=2.154,t=2.278,t=2.311,t=2.347,P all<0.05) in coronary heart disease with chronic heart failure;The observation group after treatment 14 weeks of HDL-CH(1.45±0.02)mmol/Land Apo-A(1.21±0.03)g/L lower than before treatment HDLc(1.05±0.01)mmol/L,Apo-A(0.87±0.01)g/L(t=2.234,t=2.318,P all<0.05) in coronary heart disease with chronic heart failure.Conclusion BiPAP therapy could effectively to ameliorate lipid metabolism in patients with chronic heart failure of coronary heartdisease in the long term.
RESUMO
Objective To examine the change and role of nuclear factor-kappa B(NF-?B) activity and tumor necrosis factor-alpha(TNF-?) level in patients with systemic inflammatory response syndrome(SIRS).Methods Eighty patients with SIRS were studied.The NF-?B activity in monocytes and the level of TNF-? in serum was measured.The state of illness was estimated by APACHEⅡ score.Results There was significant difference for the activity of NF-?B in patients with SIRS compared with the control group.The NF-?B activity,TNF-? level and APACHEⅡ score are higher in both resuscitation multiple organ dysfunction syndrome(MODS) group and death group than the non-MODS group and survival group correspondingly(P