目的 觀察溫針群刺聯合康復訓練治療肱骨外科頸骨折術后肩關節活動功能障礙的臨床療效。 方法 2007年8月-2009年11月，將68例肱骨外科頸骨折術后患者隨機分為溫針群刺加運動組（37例），運動療法組（31例）。溫針群刺加運動組取患肩部僵硬軟組織進行群刺，并行紅外線照射；配穴取曲尺、合谷、陽陵泉，予針刺治療，取針后活動肩關節。運動療法組先被動活動肩關節后再行主動運動訓練。治療50 d后統計療效。 結果 與治療前比較，治療結束后兩組患者的VAS、肩關節功能、活動度、活動度評分，均有統計學意義（Plt;0.05）。治療后與運動組比較，溫針群刺加運動組患者的肩關節疼痛、功能、活動度、活動度評分，均有統計學意義（Plt;0.05）。 結論 兩種治療方法對骨折術后肩關節的功能恢復均具有較好的臨床療效。與運動康復治療相比較，溫針群刺加運動訓練對骨折術后肩關節的功能恢復具有更顯著的效果。
ObjectiveTo investigate the technique of optimizing the location of femoral attachment in medial patellofemoral ligament (MPFL) reconstruction assisted with arthroscopy and evaluate the effectiveness.MethodsBetween January 2014 and September 2018, 35 patients with patellar dislocation were admitted. There were 14 males and 21 females with an average age of 22.6 years (range, 16-38 years). All patients had a history of knee sprain. The disease duration ranged from 1 to 7 days (mean, 2.8 days). Patellar dislocation occurred 2-4 times (mean, 2.5 times). The preoperative Lysholm score and Kujala score were 47.60±11.24 and 48.37±9.79, respectively. The patellar congruence angle was (31.40±6.81)°, the patellar tilt angle was (29.95±5.44)°, the lateral patellofemoral angle was (?11.46±5.18)°, and the tibial tubercle-trochlear groove distance was (16.66±1.28) mm. All patients were treated by MPFL reconstruction with the semitendinosus tendon under arthroscopy. During operation, the suture anchors were inserted into the midpoint and the 1/3 point of superomedial edge of the patella. Then, the femoral tunnels were created in medial femoral condyle through limited excision. For tendon fixation, the Kirschner wires were inserted into adductor tubercle, medial epicondyle of femur, and the midpoint between the two points, as well as the anteriorly and posteriorly. Afterwards, the changes of ligament length and tension, patellar tracking, and the relationship of patella and femoral trochlea were evaluated, thereby determining the optimized femoral attachment for MPFL reconstruction. Finally, the patellar congruence angle, patellar tilt angle, and lateral patellofemoral angle were measured by imaging to assess the relationship of patella and femoral trochlea. Moreover, Lysholm score and Kujala score were used to evaluate the knee joint function.ResultsAll incisions healed by first intention without infection. All patients were followed up 12-18 months (mean, 15.4 months). At 12 months, the Lysholm score was 94.40±3.99 and the Kujala score was 92.28±4.13, which were significant higher than those before operation (P<0.05). No patellar dislocation occurred during follow-up. At 12 months, the patellar congruence angle was (6.57±4.59)°, the patellar tilt angle was (9.73±2.82)°, the lateral patellofemoral angle was (7.14±4.63)°, which were superior to those before operation (P<0.05).ConclusionDuring the MPFL reconstruction under arthroscopy, a higher positioning accuracy for the femoral attachment and satisfactory effectiveness can be obtained by evaluating MPFL length and tension, patellofemoral joint kinematics, and patellar tracking.
Objective This study aimed to observe the protective effects of 17β-estradiol (17β-E2) to the damage of phenobarbital (PB) upon the cognition of the newly-born rats. Methods Thirty healthy 3-day-old Sprague Dawley (SD) rats were randomly divided into 3 groups: control group (10 rats), PB group (10 rats) and PB+17β-E2 group (10 rats). The control group were injected saline water with a dose of 10 mL/(kg·d); the PB group were injected with PB of 10 mg/(kg·d); the PB+17β-E2 group were injected with PB 10 mg/(kg·d) and 17β-E2 300 ug/(kg·d). All the rats were intraperitoneal injected once a day after weighing, for three continuous days. They were normally raised to one month old and then 8 rats were selected out of each group respectively for water maze test. Results The PB group was reported to have increasing latent periods in finding the underwater stage compared with control group (P<0.05). In comparison with the PB group, the PB+17β-E2 group has a shorter latent period in finding the underwater stage, and furthermore statistically significantly fewer times in finding validation areas (P<0.05). During the 120s test, the stage quadrant journey to total journey ratio of PB+17β-E2 group was lower than the ratio of PB groups, but no statistics significance had been detected. The PB+17β-E2 group exhibits no significance difference from the control group in the above-mentioned indexes. Conclusions Even a short-term injection of PB with an usual clinical dose will bring a long-term damage to an immature brain in terms of the learning ability and memory, whereas the 17β-E2 may play a protective role in this course.
Objective To investigate the correlated risk factors of deep venous thrombosis (DVT) after the laparoscopic surgery. Methods Clinical records of 16 patients with DVT and 148 patients without DVT after laparoscopic surgery in Huashan hospital from Mar.2007 to Jan.2008 were analyzed retrospectively. Results There were several factors which could induce DVT after the laparoscopic surgery, including operation time ＞1 h 〔OR=4.15 （95% CI： 1.36-12.68）〕, operative site located in hypogastrium 〔OR=2.94 （95% CI： 1.07-8.08）〕 and the number of high risk factors ≥3 〔OR=3.94 （95% CI： 1.38-11.23）〕. Conclusions The long time of operation， hypogastric operation of laparoscopic surgery and high risk factors could induce DVT. Prevention measures should be made in preoperative period.
Objective To study the effect of interleukin-6,10 (IL-6,10), C-reactive protein (CRP), and fibrinogen (FIB) on inflammatory response of lower limbs deep vein thrombosis (DVT). Methods Thirty patients with acute lower limb DVT (DVT group) and 30 volunteers (normal control group) were included in this study, and then the concentrations of serum IL-6, IL-10, CRP, and FIB were detected. Results The concentrations of serum IL-6, IL-10, CRP, and FIB of patients in DVT group before treatment were higher than those in normal control group (Plt;0.001). Compared with before treatment, the concentrations of serum IL-6, CRP, and FIB of patients after treatment were lower in DVT group (Plt;0.001), however, the concentration of serum IL-10 was higher (Plt;0.001). There was no difference of the concentrations of serum FIB between DVT group after treatment and normal control group (Pgt;0.05), but the concentrations of serum IL-6, IL-10, and CRP of patients in DVT group after treatment were higher than those in normal control group (Plt;0.05). Conclusion Inflammatory factors may involve in DVT. Therein IL-6, CRP, and FIB play important roles in acute stage of DVT, and IL-10 may have an anti-inflammatory effect.
Objective To assess the combined management of lower limb chronic venous diseases according to the CEAP classification. Methods One hundred and twenty patients were classified according to the CEAP classification. Based on clinical presentation and image study, all patients were treated with combined management plan including oppression, medication and surgery. Results All 120 patients (135 limbs) were followed up in clinic, the local recurrence rate was 18.52%(25/135). Conclusion CEAP classification expounds the developing process of lower limb chronic venous diseases. With CEAP, we can avoid the blind spot in the treatment and expand the extent of combined therapy. Accordingly, CEAP classification is useful in the treatment and diagnosis of chronic venous diseases.
目的 了解社區人群對腦卒中危險因素及癥狀的知曉現狀。 方法 隨機抽樣調查1 208名居民及112名醫務人員的人口學特征、對危險因素及預警信號的知曉現狀及其影響因素、信息來源及需求情況。 結果 90.1%、100.0%的居民及醫務人員可辨識高血壓是卒中的危險因素，而社區居民及醫務人員對年齡、糖尿病、吸煙等危險因素的認識比例分別為65.0% 和85.0%，且對危險因素的控制策略缺乏了解。87.4%、100.0%社區居民及醫務人員將一側肢體的活動障礙作為卒中的第一大預警信號，其次為頭暈、步態不穩、頭痛、言語困難、視物模糊。卒中知識得分的單因素及多因素分析示：大學文化、已婚且在職的居民及高學歷的醫務人員對卒中信息的了解程度高。卒中信息的獲取途徑依次為電視、社區醫生/講堂、報紙、雜志、網絡。 結論 西部城市社區人群卒中知識知曉率低，開展針對低學歷醫務者的卒中培訓及低學歷、獨居及退休人員的居民講堂是改善現狀的必要途徑。同時也為政府建立有效的院前早期識別及快速轉診技術提供了依據。Objective To assess the baseline knowledge of risk factors and warning signs of cerebral apoplexy in communities. Methods A total of 1 208 inhabitants and 112 medical personnel were selected by systematic sampling. The questionnaire included social-demographic data, knowledge of cerebral apoplexy risk and warning signs and influencing factors, the sources and requirement of information about cerebral apoplexy. Results Hypertension was a risk factor in 90.1% of residents and 100.0% of medical personnel. Age, diabetes and smoking were identified as the risk factor in 65.0% of medical personnel and 85.0% of residents. Medical therapy of risk factors was insufficient. The most common warning signs of cerebral apoplexy was hemiplegia, the following were vertigo, ataxia, headache, aphasia and double vision. Stepwise multiple regression analyses showed that residents who had higher educational background, spousal, workers and community worker with higher educational background had higher knowledge scores of cerebral apoplexy. The main sources of information about cerebral apoplexy were television, doctors, newspaper, magazine and network. Conclusions At present, the urban community residents in west China are lacking in knowledge about cerebral apoplexy. Going forward, targeted educational residents and medical workers should be directed at those who was highly educated, living alone, and retired. It is also provide a theoretical basis for establishing a prehospital identification and transfer treatment system based on community in developing countries.
Biomechanics-related degenerative lumbar spondylosis refers to the diseases of lumbar spine joints, muscles, fascia, and ligaments that related to maintaining lumbar spine mechanical balance and stability, which are mainly manifesting as lumbar pain and lumbocrural pain. The occurrence of biomechanics-related degenerative lumbar spondylosis is related to continuous static load and dynamic load, extra load, and aging. This article describes the etiology of biomechanics-related degenerative lumbar spondylosis, summarizes the functional compensation and structural compensation of losing balance by analyzing the characteristics of human biomechanical balance and the biomechanics of lumbar spondylolisthesis, and interprets the clinical classification of lumbar spondylosis, so as to provide a better reference for the diagnosis and treatment of lumbar spine diseases.
ObjectiveTo observe the effect of kinesio tape (KT) combined with progressive resistance training (PRT) in patients with subacromial impingement syndrome (SIS), and to explore whether the direction of KT affects the therapeutic effect of SIS.MethodsBetween May 2017 and March 2019, 90 participants with SIS in West China Hospital, Sichuan University were randomly divided into three groups, with 30 participants in each group. Participants were treated with KT combined with PRT, and the direction of the KT is from the proximal end of the rotator cuff muscles to the distal end in group A. Participants were treated with KT combined with PRT, and the direction of the KT is from the distal end of the rotator cuff muscles to the proximal end in group B. Participants were treated with PRT alone in group C. Visual Analog Scale (VAS) was used to evaluate the pain in patients at rest, during movement and at night; range of motion (ROM) of shoulder and the disabilities of the arm, shoulder and hand (DASH) outcome questionnaire were used to measure the physical function before treatment and after 1 week and 2 weeks.ResultsAfter 1 week of treatment, ROM of shoulder abduction, internal rotation and DASH scores in group A were significantly improved compared with those in group B and C (P<0.05). After 2 weeks of treatment, the nighttime VAS score, ROM of shoulder abduction, internal rotation and DASH score scores in group A were significantly improved compared with those in group B and C (P<0.05). The VAS score during movement, nighttime VAS score, ROM of shoulder (except external rotation) and DASH score in group A were significantly improved after 1 week and 2 weeks of treatment (P<0.05); and after 2 weeks of treatment, the nighttime VAS score, ROM of shoulder flexion and internal rotation in group B were significantly improved compared with those before treatment (P<0.05). After 2 weeks of treatment, the VAS score during movement, nighttime VAS score, ROM of shoulder (except external rotation) in group C were significantly improved compared with those before treatment (P<0.05).ConclusionKT combined with PRT is more effective than PRT alone in the treatment of SIS, and the therapeutic effect is related to the direction of the tape.
When performing eye movement pattern classification for different tasks, support vector machines are greatly affected by parameters. To address this problem, we propose an algorithm based on the improved whale algorithm to optimize support vector machines to enhance the performance of eye movement data classification. According to the characteristics of eye movement data, this study first extracts 57 features related to fixation and saccade, then uses the ReliefF algorithm for feature selection. To address the problems of low convergence accuracy and easy falling into local minima of the whale algorithm, we introduce inertia weights to balance local search and global search to accelerate the convergence speed of the algorithm and also use the differential variation strategy to increase individual diversity to jump out of local optimum. In this paper, experiments are conducted on eight test functions, and the results show that the improved whale algorithm has the best convergence accuracy and convergence speed. Finally, this paper applies the optimized support vector machine model of the improved whale algorithm to the task of classifying eye movement data in autism, and the experimental results on the public dataset show that the accuracy of the eye movement data classification of this paper is greatly improved compared with that of the traditional support vector machine method. Compared with the standard whale algorithm and other optimization algorithms, the optimized model proposed in this paper has higher recognition accuracy and provides a new idea and method for eye movement pattern recognition. In the future, eye movement data can be obtained by combining it with eye trackers to assist in medical diagnosis.