Objective To investigate the efficiency of manual reduction combined with uni-lateral percutaneous kyphoplasty (PKP) in treating osteoporotic vertebral compression fracture (OVCF). Methods Between May 2005 and May 2009, the manual reduction combined with uni-lateral PKP was appl ied to treat 42 patients with OVCF (group A), and the simple uni-lateral PKP was appl ied to treat 43 patients with OVCF (group B) at the same period. The visual analogue scale (VAS), the vertebral height, and the Cobb angle were determined before operation, and at 3 days and 6 months after operation. Ingroup A, there were 6 males and 36 females aged 59-93 years (76.5 years on average) with an average disease duration of 7 days (range, 3 hours to 21 days); 27 segments of thoracic vertebrae and 31 segments of lumbar vertebrae were involved, including 15 segments at mild degree, 38 segments at moderate degree, and 5 segments at severe degree according to degree classification system of compression fractures of Zoarski and Peh. In group B, there were 9 males and 34 females aged 54-82 years (75.3 years on average) with an average disease duration of 7 days (range, 1 hour to 20 days); 26 segments of thoracic vertebrae and 35 segments of lumbar vertebrae were involved, including 21 segments at mild degree, 36 segments at moderate degree, and 4 segments at severe degree according to degree classification system of compression fractures of Zoarski and Peh. There were no significant difference (P gt; 0.05) in sex, age, affected site, degree, and disease duration between 2 groups. Results There was no significant difference (P gt; 0.05) in operative time, blood loss, or injected cement volume between 2 groups. No serious compl ication or death occurred in 2 groups. Cement leakage was observed in 4 cases (9.5%) of group A and in 5 cases (11.6%) of group B. The VAS scores after operation significantly decreased in 2 groups (P lt; 0.01). At 3 days and 6 months after operation, the VAS scores in group A were significantly lower than those in group B (P lt; 0.05). The postoperative compression rates of affected vertebral body in 2 groups significantly decreased (P lt; 0.01). The compression rates of affected vertebral body at 3 days and 6 months after operation, and the height recovery rate at 3 days after operation in group A were superior to those in groupB (P lt; 0.05). The postoperative Cobb angles in 2 groups were significantly diminished (P lt; 0.01). The Cobb angles at 3 days and 6 months after operation, and the recovery rate at 3 days after operation in group A were superior to those in group B (P lt; 0.05). Conclusion The cl inical efficiency of the manual reduction combined with uni-lateral PKP is superior to that of simple uni-lateral PKP in treatment of severe OVCF.
ObjectiveTo study the feasibility of using propofol and remifentanil for reduction of shoulder joint dislocation in the conscious elderly patients, and compare its efficacy with brachial plexus block anesthesia.
MethodsSeventy elderly patients (American Sociaty of Anesthesiologist physical statusⅠ-Ⅱ) who underwent shoulder dislocation reduction in our hospital between August 2011 and December 2013 were randomly divided into two groups, each group having 35 cases. Patients in group A received brachial plexus nerve block anesthesia downlink gimmick reset, while patients in group B received the use of remifentanil-propofol and lidocaine compound liquid intravenous drop infusion for anesthesia downlink manipulative reduction. After successful anesthesia, two groups of patients were treated with traction and foot pedal method (Hippocrates) to reset. We observed the two groups of patients in the process of reduction, and recorded their hemodynamic changes, reset time, discharge time, postoperative satisfaction, intra-operative memory, breathing forgotten (breathing interval was longer than 15 seconds) and visual analogue scale (VAS) scores, and then comparison was made between the two groups.
ResultsPatients in both the two groups successfully completed manipulative reduction. Compared with group A, patients in group B had more stable hemodynamic indexes during the process of reduction, shorter reduction time, better anesthesia effect and higher postoperative satisfaction degree, and the differences were statistically significant (P<0.05). There was no significant difference in terms of time of leaving the operation room between the two groups (P>0.05). VAS score was higher in group A than that in group B (P<0.05). The occurrence of intra-operative memory amnesia and breathing forgotten phenomenon existed in part of the patients after operation in group B, but they did not occur in patients in group A.
ConclusionRemifentanyl propofol-lidocaine compound fluid can be safely used in conscious elderly patients for shoulder joint dislocation reconstructive surgery, and it functions quickly with complete analgesia and stable hemodynamic indexes.
ObjectiveTo compare the effects of povidone iodine handwashing with brush and brush-free handwashing on the hand skin condition of nurses in operation room.
MethodA random sampling method was used to choose 150 nurses from the operation room of a grade-3 class-A hospital as our study subjects from June 2013 to December 2014. They were randomly divided into control group and study group according to the random number table with 75 in each. The control group used the traditional povidone iodine handwashing with brush, while the study group applied brush-free handwashing method. Then, we compared the hand skin condition and disinfection effect of these two kinds of handwashing methods.
ResultsThe control group had dry skin in 34 nurses (45.3%), dry desquamation in 9 (12.0%), tight feeling in 51 (68.0%), and allergy in 5 (6.7%). The study group had dry skin in 19 nurses (25.3%), dry desquamation in 0 (0.0%), tension in 21 (28.0%), and allergy in 0 (0.0%). The differences between the two groups were statistically significant (P<0.05).
ConclusionsThe brush-free handwashing method is able to achieve the requirements of surgical hand disinfection, and can protect the skin of nurses in operation room.
ObjectiveTo explore the clinical efficacy of fascial manipulation (FM) treatment in patients with chronic ankle instability (CAI).MethodsThe clinical data of CAI patients who received rehabilitation treatment in the Department of Rehabilitation Medicine of the Second Hospital of Jilin University from October 2018 to December 2020 were retrospectively collected. According to different treatment methods, patients were divided into balance training (BT) group and FM group. The BT group received BT for 4 weeks, while the FM group received BT for 4 weeks after FM treatment. Propensity score matching (PSM) was used for 1∶1 matching to compare the effects of different treatment options on the dysfunction of CAI patients. Foot and Ankle Ability Measure (FAAM) [including FAAM-activity of daily living (FAAM-ADL), activity of daily living (ADL) self-scoring, FAAM-sports (FAAM-S), and sports self-scoring], center of pressure (COP), foot lift test (FLT) were used to evaluate the changes in balance function and symptoms pre-treatment and post-treatment.ResultsA total of 52 patients were included, including 24 cases in FM group and 28 cases in BT group. Finally, after PSM method, 34 patients were included, 17 cases in each group. Before intervention, there was no significant difference in FAAM, COP and FLT between the two groups (P>0.05). After the intervention, FAAM-ADL, ADL self score, COP and FLT in the FM group were better than those in the BT group (P<0.05); there was no significant difference between FAAM-S and exercise self score (P>0.05). Before and after the intervention, FAAM, COP and FLT were improved in both groups (P<0.05). The improvement of FAAM ADL, ADL self-score and the decrease of COP in FM group were higher than that of the BT group (P<0.05). Comparison of FAAM-S, exercise self score and FLT before and after intervention, there was no significant difference between the two groups (P>0.05).ConclusionBT can improve the function of patients with CAI, and the combination of FM is more effective in improving the ability of daily living and static balance.
ObjectiveTo evaluate mid-term effectiveness of manipulation under anesthesia combined with arthroscopic capsular release and subacromial debridement for primary frozen shoulder.MethodsBetween January 2013 and December 2017, 33 patients of primary frozen shoulder were treated with manipulation under anesthesia combined with 360° arthroscopic capsular release and subacromial debridement. There were 10 males and 23 females, aged from 37 to 65 years, with a mean age of 50.9 years. The affected shoulder on left side in 17 cases and on right side in 16 cases. The disease duration was 6-13 months (mean, 8.4 months). Before and after operation, the visual analogue scale (VAS) score was used to evaluate the shoulder joint pain, Constant score was used to evaluate the shoulder joint function, and the flexion, abduction, and external rotation of shoulder joint were recorded. The internal rotation function was assessed based on the vertebral plane that the thumb could reach after internal rotation of the affected shoulder joint (the rank of internal rotation vertebra). X-ray film was taken to measure the distance of the subacromial space.ResultsThere was no fracture or labrum tear in all patients, and all the incisions healed by first intention. All the 33 patients were followed up 20-31 months, with an average of 24.1 months. During the follow-up, there was no complication such as wound infection and nerve injury. At last follow-up, the range of motion of shoulder flexion, abduction, and external rotation, the rank of internal rotation vertebra, the VAS score, Constant score, and subacromial space were significantly improved when compared with preoperative ones (P<0.05).ConclusionManipulation under anesthesia combined with arthroscopic capsular release and subacromial debridement can achieve a good mid-term effectiveness without complication for primary frozen shoulder.
ObjectiveTo provide an overview of systematic reviews on the efficacy and safety of massage for the treatment of cervical spondylotic radiculopathy.MethodsCNKI, WanFang Data, VIP, CBM, PubMed, The Cochrane Library and EMbase databases were electronically searched to collect the systematic reviews on the efficacy and safety of massage for the treatment of cervical spondylotic radiculopathy from inception to December 30th, 2018. Two reviewers independently screened the literature and extracted the data, applied the AMSTAR2 scale to evaluate its methodological quality, and GRADE to evaluate the quality of the evidence.ResultsA total of 7 systematic reviews/meta-analysis were included. The AMSTAR2 scale evaluation showed that the quality of the included studies was extremely low. The GRADE evidence grading results showed that the quality of the VAS score outcome index of the two literatures was intermediate, and the quality of the OASCSR outcome index of one literature was intermediate. The quality of the remaining outcome indicators reported is low or very low.ConclusionThe available evidence shows that the efficacy and safety of manual treatment of cervical spondylotic radiculopathy is acceptable, but the overall methodological quality of the systematic review is extremely low, and the quality level of evidence is generally low. The future clinical trials and systematic reviews should be strictly followed. The scientific research design of the medical science provides high-quality evidence and provides reference for clinical practice.
目的 比較單純手法復位和手法復位合并口服抗眩暈藥治療良性陣發性位置性眩暈（BPPV）的短期和長期療效。 方法 將2004年1月－2011年6月期間收治的236例BPPV患者隨機分為兩組，對照組112例采用單純手法復位，觀察組124例在手法復位基礎上配合口服抗眩暈藥治療，兩組均于1周和3個月后復查，并隨訪觀察1年，且比較其療效。 結果 觀察隨訪1年后，對照組總治愈率92.86% (104/112），觀察組治愈率為93.54%（116/124），兩者比較差異無統計學意義。 結論 單純手法復位和手法復位合并口服抗眩暈藥治療BPPV其療效相當，但可作為BPPV患者的首選治療方法。Objective To evaluate the short-term and long-term effect of canalith repositioning procedures with or without anti-vertigo drugs on benign paroxysmal positional vertigo (BPPV). Methods A total of 236 cases of BPPV that were treated with particle repositioning maneuver with medicine treatment from January 2004 to June 2011. The patients were divided into control group (112 patients, underwent canalith repositioning procedures) and observation group (124 patients, underwent canalith repositioning procedures with medication of anti-vertigo drugs). The two groups were reappraised after one week and three months respectively, and the follow-up duration was one year. Results The success rate was 92.86% (104/112) in the control group and 93.55%(116/124) in the observation group one year after the treatment. The difference between the two groups was not significant. Conclusion The effect of canalith repositioning procedures with or without anti-vertigo drugs on BPPV does not differ much from each other.
