ObjectiveTo compare the effectiveness and radiological changes between KMC interspinous dynamic reconstruction and Coflex for degenerative lumbar spinal disorders and evaluate the clinical outcome of the KMC interspinous dynamic internal fixation for degenerative lumbar spinal disorders. MethodsA randomized controlled double-blind trial was conducted. Thirty-three patients with degenerative lumbar spinal disorders were divided into 2 groups between May 2011 and July 2012, 19 patients received Coflex treatment (group A), and 14 patients received KMC (group B). Single Coflex or KMC fixation was used. There was no significant difference in age, gender, disease duration, affected segment, and disease diagnosis between 2 groups (P>0.05). The Oswestry disability index (ODI) score and visual analogue scale (VAS) score were used to evaluate the effectiveness. The anterior disc height, middle disc height, posterior disc height, and foramen intervertebral height and width of operated segment were measured and compared between at preoperation and last follow-up on the X-ray films. Range of motion (ROM) of operated segment and adjacent segment was measured. ResultsThere was no significant difference in operation time, intraoperative blood loss, postoperative recovery time, and hospitalization time between 2 groups (P>0.05). The patients were followed up 12-24 months (mean, 16.2 months) in group A and 12-26 months (mean, 17.9 months) in group B. No shift, loosening, or breaking of internal fixation occurred. The ODI score and VAS score were significantly decreased at last follow-up when compared with preoperative scores (P<0.05); there was no significant difference in the ODI score and VAS score at preoperation and last follow-up, and in improvement rate at last follow-up between 2 groups (P>0.05). The middle disc height and posterior disc height, and foramen intervertebral height and width were significantly increased when compared with preoperative ones (P<0.05), while there was no significant difference in anterior disc height (P>0.05). At last follow-up, ROM of the operated segments was significantly improved when compared with preoperative one in 2 groups (P<0.05), but no significant difference was found at the upper adjacent level (P>0.05). There was no significant difference in ROM of the operated segment and upper adjacent segment between 2 groups at preoperation and last follow-up (P>0.05). ConclusionThe early effectiveness is satisfactory to treat degeneration lumbar spinal disorders with KMC interspinous dynamic internal fixation.
Multi-layer perceptron (MLP) neural network belongs to multi-layer feedforward neural network, and has the ability and characteristics of high intelligence. It can realize the complex nonlinear mapping by its own learning through the network. Bipolar disorder is a serious mental illness with high recurrence rate, high self-harm rate and high suicide rate. Most of the onset of the bipolar disorder starts with depressive episode, which can be easily misdiagnosed as unipolar depression and lead to a delayed treatment so as to influence the prognosis. The early identification of bipolar disorder is of great importance for patients with bipolar disorder. Due to the fact that the process of early identification of bipolar disorder is nonlinear, we in this paper discuss the MLP neural network application in early identification of bipolar disorder. This study covered 250 cases, including 143 cases with recurrent depression and 107 cases with bipolar disorder, and clinical features were statistically analyzed between the two groups. A total of 42 variables with significant differences were screened as the input variables of the neural network. Part of the samples were randomly selected as the learning sample, and the other as the test sample. By choosing different neural network structures, all results of the identification of bipolar disorder were relatively good, which showed that MLP neural network could be used in the early identification of bipolar disorder.
Purpose Observation on changes of choroidal circulation in 21 cases (42 eyes) of retinal dystrophies. Methods Fundus fluorescein angiography (ICGA) were used for comparartive analyses of the retinal and choroidal blood circulation of 21 cases (42 eyes) of retinal dystrophic diseases. Results The changes of choroidal circulation,i.e.slow perfusion or filling defects were observed in four kinds of retinal dystrophies. Conclusion ICGA may assist in providing valuable informations on choroidal circulation of retinal dystrophic diseases. (Chin J Ocul Fundus Dis,1998,14:88-91)
Objective To assess the efficiency of iodised salt on iodine deficiency disorders. Methods we searched MEDLINE (1996 to December 2009), EMbase (1974 to December 2009), The Cochrane Library (Issue 4, 2009), Current Controlled Trials, The National Research Register, CBM (1983 to December 2009) and CNKI (1994 to December 2009), and traced the literature of the reference. The included objects were the resident of the iodine deficiency area and the age, the race. The sex was not limited. The fortified salt and the iodized salt effects were compared and the research quality was evaluated. Meta-analyses were conducted by the RevMan5.0 software. Results Eight studies involving 1 503 people were included. The goiter prevalence of the fortified salt which combined iodine with iron was lower than that of iodised salt [MD=1.22, 95%CI (0.90, 1.54)]. So was the thyroid gland volume [OR=1.88, 95%CI(1.01, 3.47)]. But the fortified salt which combined iodine with VA did not show this. Conclusion The fortified salt and the iodized salt can obviously improve the iodine nutritional status of people. The fortified salt has enhanced the effect while the iodized salt prevents iodine deficiency disorders, but more high grade randomized controlled trials are needed to confirm this.
【摘要】 目的 探討降高血壓藥物聯合抗焦慮抑郁藥物萬拉法新治療老年性原發高血壓伴焦慮抑郁障礙的療效及安全性。 方法 納入2006年10月-2008年10月我院門診和住院診治的老年性原發高血壓伴焦慮抑郁障礙患者100例,隨機分為干預組和對照組。所有患者給予常規降壓藥物治療,干預組另外給予萬拉法新治療,治療12周后評價臨床療效。結果 干預組臨床降壓療效總有效率940%,顯著高于對照組總有效率800%(Plt;005)。兩組患者的收縮壓、舒張壓與治療前比較均顯著改善(Plt;005),干預組患者與對照組比較血壓明顯改善(Plt;005)。干預組臨床抗焦慮抑郁療效總有效率960%,顯著高于對照組總有效率580%(Plt;005)。兩組均無明顯的不良反應。結論 降高血壓藥物聯合抗焦慮抑郁藥物萬拉法新治療老年性原發高血壓伴焦慮抑郁障礙療效肯定,且安全可靠,值得臨床推廣應用。【Abstract】 Objective To investigate the efficacy and safety of antihypertensive drugs combined with antianxiety depression drug venlafaxine for treatment of patients with senile primary hypertension (SPH) and anxietydepression disorder (AD). Methods One hundred SPH patients with AD with were randomly divided into an intervention group and a control group. All cases were given antihypertensive drugs medication,while the intervention group was given venlafaxine. After 12 weeks of treatment,the clinical efficacy was evaluated. Results The antihypertensive efficacy rate in the intervention group was 940%,significantly higher than that of the control group 800% (Plt;005). The systolic blood pressure(SBP)and diastolic blood pressure (DBP) of the two groups significantly improved compared with those before treatment (Plt;005), and the intervention group’ SBP and DBP improved significantly than those of the control group (Plt;005). The total effective rate of antianxiety depression efficacy of the intervention group was 960%, significantly higher than that of the control group 580% (Plt;005). The two groups had no significant adverse reactions. Conclusion For patients with senile primary hypertension and anxietydepression disorder,the combination medication with antihypertensive drugs and venlafaxine was safe,reliable and worthy of clinical application.
Objective To explore the relation between stigma and substance use of patients with substance use disorder and explore the impact of learning addiction medicine massive open online course (MOOC) on patients’ stigma, depression and anxiety. Methods Patients with substance use disorder in Meishan Detoxification Center from January 11 to 18, 2020 were selected. The patients were randomly divided into control group and teaching group. Both groups participated in regular labor reform while the teaching group attended extra MOOC course. The general demographic data and the duration and amount of substance use were collected before intervention. Before and after intervention, all the patients completed scales including Chinese Version of Substance Use Stigma Mechanisms Scale (SUSMS-C), Zung Self-Rating Depression Scale (SDS) and Zung Self-Rating Anxiety Scale (SAS). The correlation between stigma and depression, anxiety, substance use characteristics were analyzed, as well as the changes of stigma, depression and anxiety before and after MOOC intervention.Results A total of 78 patients were included, including 41 in the control group and 37 in the teaching group. There was no correlation between the scores of SUSMS-C and the duration or amount of substances use (P>0.05). SAS score and SDS score were positively correlated with the total score of stigma, internalized stigma, enacted stigma (family) and enacted stigma (healthcare providers) (P<0.05). SDS scores and SAS scores had no correlation with the anticipated stigma (P>0.05). After intervention, the total score of stigma, anticipated stigma (family) and anticipated stigma (healthcare providers) in the teaching group decreased (P<0.05). In the control group, only anticipated stigma (family) decreased (P=0.047). There was no significant difference in other SUSMS-C items, SAS scores, or SDS scores between the two groups before and after intervention (P>0.05). Conclusions Stigma may not be able to protect patients with substance use disorder from using substances. Instead, stigma may potentially cause negative emotional consequences like depression and anxiety. The addiction medicine MOOC can be used as an intervention to reduce the stigma of patients with substance use disorder.
Objective To compare the effectiveness and radiological changes of posterior decompression combined with Coflex interspinous dynamic reconstruction or lumbar 360° fusion for degenerative lumbar spinal disorders at L4, 5. MethodsBetween October 2008 and November 2010, a comparative study was carried out on patients with degenerative lumbar spinal disorders at L4, 5. In group A, 29 patients underwent posterior decompression combined with Coflex interspinous dynamic reconstruction; there were 20 males and 9 females with an average age of 45.1 years (range, 21-67 years); and the disease duration was 2 months to 4 years. In group B, 31 patients underwent posterior decompression combined with lumbar 360° fusion treatment; there were 16 males and 15 females with an average age of 56.2 years (range, 32-86 years); and the disease duration was 3 months to 6 years. Except the age, there was no significant difference in gender, disease duration, and etiology etc. between 2 groups (P gt; 0.05). The results were assessed by Japanese Orthopaedic Association (JOA), visual analogue scale (VAS) scores, and Oswestry disabil ity index (ODI). The range of motion (ROM) and intervertebral height of affected and adjacent segments, and the ROM of lumbar were measured before operation and last follow-up. Results Significant differences were found in the operative time and blood loss between 2 groups (P lt; 0.05). Intraoperative dural tear occurred in 1 case of group B, spinal canal venous plexus hemorrhage in 1 case of group B, and postoperative cerebrospinal fluid leakage in 2 cases of group A and B respectively, showing no significant difference (χ2=0.119, P =0.731). The follow-up was 12-21 months in group A and was 12-23 months in group B. At the last follow-up, the JOA, VAS scores, and ODI of groups A and B were significantly improvedwhen compared with the preoperative values (P lt; 0.05). The VAS score of group A was significantly higher than that of group B (P lt; 0.05). There was no significant difference in the intervertebral height of L4, 5 and L5, S1 of groups A and B between pre- and post-operation (P gt; 0.05). In group B, the intervertebral height of L3, 4 was significantly reduced (P lt; 0.05) compared with the preoperative one. There was no significant difference in the ROM of L5, S1 and ROM of lumbar in groups A and B between preand post-operation (P gt; 0.05). At last follow-up, the ROM of L4, 5 was significantly reduced in group A (P lt; 0.05), and the ROM of L3, 4 was significantly increased in group B (P lt; 0.05). Except significant differences in the intervertebral height and ROM of L3, 4 between 2 groups (P lt; 0.05), no significant difference was found in other parameters (P gt; 0.05). Conclusion Posterior decompression combined with Coflex interspinous dynamic reconstruction has the same effectiveness as lumbar 360° fusion in treating degenerative lumbar spinal disorders at L4, 5, but the former has a protective effect on the adjacent segments of fusion and is recommended for initial treatment of young adults and the elderly and frail patients with recurrent.
In order to guide diagnosis and treatment in children with sleep disordered breathing aged 1 to 23 months, the European Respiratory Society(ERS) summarized the evidence and released the European Respiratory Society statement based on clinical experience in 2016. This article aims to interpret the ERS statement. Children with apparent upper airway obstruction during wakefulness and those with SDB symptoms and complex conditions requires treatment. Adenotonsillectomy and continuous positive airway pressure are the most frequently used treatment measures along with interventions targeting specific conditions. Obstructive SDB in children aged 1 to 23 months is a multifactorial disorder that requires objective assessment and treatment of all underlying abnormalities.
Objective To assess the evidence of Cochrane systematic reviews on the treatment of temporomandibular disorders (TMD) as well as the methodological quality of all randomized controlled trials (RCTs) of the included systematic reviews. Methods The Cochrane Library (Issue 3, 2008) was searched for systematic reviews on the treatment of temporomandibular disorders. The risk of bias was assessed independently by two authors. Results Three systematic reviews involving 25 RCTs were included. The methods of 23 studies were rated as of lower quality with high risk of various biases. Only 2 studies were of high quality. Conclusion There is insufficient or inconsistent evidence to support the use of hyaluronate, occlusal adjustment, and stabilization splint therapy for the treatment of TMD. The overall quality of RCTs about the treatment of TMD is generally low. Analysis of the included trials showed that some trials had no clear description of randomization methods, allocation concealment, sample size calculation, and intention-to-treat analysis. To improve the quality of the reporting of RCTs, clinical trial registration and the revised Consolidated Standards of Reporting Trials (CONSORT) statement should be introduced into the trial design and strictly followed.
Patients with autoimmune encephalitis are mainly characterized by behavioral, mental and motor abnormalities, neurological dysfunction, memory deficits and seizures. Different antibody types of autoimmune encephalitis its pathogenesis, clinical characteristics are different, in recent years found immune related epilepsy is closely related to autoimmune encephalitis, based on autoimmune encephalitis type is more, we choose more common autoimmune encephalitis, expounds its characteristics, to help clinical diagnosis.