ObjectiveTo summarize the current status and progress of the treatment of chronic lateral ankle instability (CLAI). MethodsThe literature about the anatomical repair of CLAI at home and abroad was reviewed and summarized. ResultsBroström and its modified operations are the most common surgical treatment of CLAI. The operations showed satisfactory clinical outcomes in the short-, medium-, and long-term follow-up and low complication rate. Suture anchor technique and arthroscopic techniques are gradually used in Broström and its modified operations with satisfactory short-term effectiveness, but long-term effectiveness needs further observation because of the limitation of the short clinical application time. ConclusionBroström and its modified operations are effective, convenient, and safe to treat CLAI. Based on the researches of biomechanics and dynamic anatomy, the more personalized design of the rehabilitation program is the further research direction.
Coronary artery bypass grafting (CABG) is an effective method for the treatment of coronary heart disease at present. However, there is still a high rate of vein graft occlusion after CABG, which has a serious impact on the short and long-term clinical results. Venous access technique has been considered as an important factor on affecting the long-term patency rate. Compared with harvesting technology of the open saphenous vein harvesting, no-touch technology retained the surrounding tissue and vascular adventitia of great saphenous vein, and it avoided the high pressure of expansion vein. After CABG was performed by using the no-touch technique, the vein grafts obtained a better short and long-term patency rate, but the effect still needs further clinical verification.
Heart failure is a leading cause of death in human populations. Because of the insufficient numbers of donor hearts, ventricular assist as a way for the treatment of heart failure and its clinical use is increasing. Initially ventricular assist devices were approved as a bridge-to-recovery indication, and these systems are now increasingly being used as a bridge-to-transplant (BTT) , destination therapy (DT) or permanent support. According to the different structure and working mechanism, ventricular assist device is generally divided into three generation. This review makes a summary on the type of blood pump and its research progress in clinical application.
ObjectiveTo explore the clinical effectiveness of two kinds of treatment methods to nurse wound after tracheotomy. MethodsWe collected 108 cases and randomly divided them into two groups between March 2012 and May 2013. The experimental group (n=52) received tracheotomy care with PermaFoam dressing, while the control group (n=56) was treated with traditional sterile absorbent gauze. We analyzed the differences in terms of infection of wound, errhysis and frequency of dressing changes between the two groups. ResultsThe experimental group had a lower rate of wound infection than the control group (P<0.05). Moreover, the experimental group was superior to the control group in the total number of dressing changes, wound redness and oozing (P<0.05). ConclusionPermaFoam dressing can reduce wound complications and frequency of dressing changes effectively. It is easy to operate, and can reduce the workload of clinical nursing, and deserves clinical application.
ObjectiveTo evaluate the effectiveness of transforaminal lumbar interbody fusion (TLIF) via Luxor retractor associated with Mantis pedicle screw for the treatment of moderate or severe lumbar spondylol isthesis (LSL). MethodsA retrospective analysis was made on the cl inical data of 32 patients with LSL treated with TLIF via Luxor retractor associated with Mantis pedicle screw between June 2010 and June 2012. There were 20 males and 12 females, with the mean age of 48 years (range, 36-69 years). LSL occurred at the L4, 5 in 17 patients and at the L5, S1 in 15 patients. Of them, 18 cases were rated as Meyerding grade Ⅱ, and 14 cases as grade Ⅲ. The disease duration was 8 months to 6 years (mean, 3.5 years). The operation time, intraoperative blood loss, and preoperative and postoperative (1 week and 1 year) intervertebral height and sl ipping angle were recorded, and the sl ipping rate was calculated; Japanese Orthopaedic Association (JOA) score was used for cl inical efficacy assessment. ResultsThe operation time was 90-130 minutes (mean, 110 minutes); intraoperative blood loss was 120-300 mL (mean, 210 mL). Incisions healed by first intention. All patients were followed up 24-36 months (mean, 28 months), and no complications of leakage of cerebrospinal fluid and nerve root injury occurred; X-ray films showed satisfactory reduction of spondylolisthesis and good position of pedicle screw and interbody fusion cage. The mean bone fusion time was 4.0 months (range, 3.8-6.0 months). The JOA score, sl i pping rate, sl i pping angle, and intervertebral height at 1 week and 1 year after operation were significantly improved when compared with preoperative ones (P<0.05), but no significant difference was found between at 1 week and at 1 year after operation (P>0.05). ConclusionTLIF via Luxor retractor associated with Mantis pedicle screw fixation is a safe and effective minimally invasive technique in treating moderate or severe LSL.
The purpose of this study is to determine how restricting inversion-eversion and pronation-supination motions of the ankle joint complex influences the stability of human gait. The experiment was carried out on a slippery level ground walkway. Spatiotemporal gait parameter, kinematics and kinetics data as well as utilized coefficient of friction (UCOF) were compared between two conditions, i.e. with restriction of the ankle joint complex inversion-eversion and pronation-supination motions (FIXED) and without restriction (FREE). The results showed that FIXED could lead to a significant increase in velocity and stride length and an obvious decrease in double support time. Furthermore, FIXED might affect the motion angle range of knee joint and ankle joint in the sagittal plane. In FIXED condition, UCOF was significantly increased, which could lead to an increase of slip probability and a decrease of gait stability. Hence, in the design of a walker, bipedal robot or prosthetic, the structure design which is used to achieve the ankle joint complex inversion-eversion and pronation-supination motions should be implemented.
Dental composite resin is a kind of material which has been widely used in dental restoration. Research has found that the influence of residual monomer on the material mechanical, chemical and biological properties cannot be ignored. This paper elaborates these harms of residual monomers. The effects of resin matrix, inorganic filler and initiating system, illumination, secondarily treatment on the degree of conversion were also analyzed. The paper also discusses the effective measures to increase the conversion, and offers theoretical basis for the clinical application and development of composite resin.
ObjectiveTo study the relationship between brain white matter fiber occult lesions and P100 wave latency of visual evoked potential (VEP) in neuromyelitis optica (NMO) patients by diffusion tensor imaging (DTI). MethodsTwenty patients with NMO who were treated between July 2008 and April 2009 were selected as the trial group. According to the VEP test, the latency of P100 wave was prolonged, the NMO patients were divided into VEP abnormal group (trial group 1) and VEP normal group (trial group 2). Twenty healthy adult volunteers served as the control group. The DTI examination in brain was done to measure the fractional anisotropy (FA) value of optic nerve (FAn), optic tract (FAt), and optic radiation (FAr);and the mean diffusivity (MD) value of optic nerve (MDn), optic tract (MDt), and optic radiation (MDr). The FA, MD, and P100 wave latency were compared between groups, and the correlation between MD, FA, and P100 wave latency of NMO were analyzed. ResultsIn the 20 NMO patients, 13 patients with VEP had prolonged bilateral P100 wave latency prolongation or no wave (trial group 1), and 7 patients had normal bilateral P100 wave latency (trial group 2). Compared with the trial group 2 and the control group, the FA values were significantly decreased, and the MD values were significantly increased in the trial group 1 (P<0.05). There was no significant difference in the FA and MD values between the trial group 2 and the control group (P>0.05). All FA (FAn, FAt, and FAr) values of each part of NMO patients were negatively correlated with the latency of P100 wave (P<0.05), all MD (MDn, MDt, and MDr) values were positively correlated with the latency of P100 wave (P<0.05). ConclusionDTI could show small pathylogical changes in the white matter fibers of visual pathway, and there is a correlation between DTI and VEP in NMO, suggesting that a more comprehensive assessment to the condition and prognosis can be made through the VEP in the clinical indicators.
ObjectiveTo observe the clinical efficacy of temperature-controlled self-heated pain relief plasters in the treatment of chronic nonspecific lower back pain, and to investigate the quality of life of patients. MethodsPatients with chronic nonspecific lower back pain were randomly divided into a trial group and a control group. The trial group was treated with temperature-controlled self-heated pain relief plasters, while the control group was treated with meloxicam tablets for oral use. The outcome measures including the visual analogue pain scale (VAS), Japanese Orthopedic Association (JOA) scores for the management of lower back pain, and Oswestry disability index (ODI score) were collected before treatment and after 6-month follow-up. SPSS 13.0 software was used for statistical analysis. ResultsA total of 96 patients was included (48 patients in each group), of which 68 patients (36 in the trial group and 32 in the control group) completed the treatment. The results of intention-to-treat (ITT) and per-protocol (PP) analyses showed that the total effectiveness rate of the trial group was higher than that of the control group with significant differences (all P values < 0.05). Compared with those before treatment, the JOA scores and ODI scores of the two groups were all improved after 6-month follow-up (all P values < 0.05). But no significant difference was found between the two groups in the two scores after 6-month follow-up (all P values > 0.05). During the follow-up, there were 3 and 8 patients with recurrence of lower back pain in the trial group and the control group, respectively. ConclusionThe clinical effect of temperature-controlled self-heated pain relief plasters in the treatment of chronic nonspecific lower back pain is satisfactory, the quality of life of patients is improved obviously, and the therapy is simple, safe, inexpensive, and worthy of clinical promotion.
ObjectiveTo systematically review the characteristics of adverse transfusion reaction in Grade Three Class-A hospitals in China, and to provide scientific evidence for related control and prevention work. MethodsSuch databases as the PubMed, EMbase, The Cochrane Library (Issue 11, 2014), CNKI, VIP, WanFang Data and CBM were searched for studies investigating the characteristics of adverse transfusion reaction with ≥6 months observation time in Grade Three Class-A hospitals in China up to November 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality of included studies. Then, meta-analysis was performed by using the R 3.1.1 software. ResultsSeventy-two studies involving 1 660 472 cases of blood transfusion were included. The results of pooled analysis showed that the total number of adverse transfusion reaction rate was 0.58% (95%CI 0.48 to 0.69). Sub-group analysis shows that the blood transfusion adverse reaction rates in the eastern, central and western regions were 0.42% (95%CI 0.31 to 0.55), 0.55% (95%CI 0.41 to 0.70), 0.56% (95%CI 0.43 to 0.70), respectively; and there were statistical differences between regions (P<0.05). Different types of adverse transfusion reaction rates were 38.85% (95%CI 34.27 to 43.53) for non hemolytic febrile reaction and 55.67% (95%CI 50.79 to 60.50) for allergic. The adverse reactions incidence of different kinds of blood products transfusion occurred were 0.41% (95%CI 0.32 to 0.50) in red blood cell, 0.57% (95%CI 0.43 to 0.72) in plasma, 1.00% (95%CI 0.73 to 1.30) in platelet. The incidence of adverse reaction of platelet transfusion was significantly higher than that of red blood cell and plasma (P<0.05). ConclusionThere is a big gap between domestic and foreign blood transfusion adverse reaction reports, therefore comprehensive measures should be taken for further prevention and control.