ObjectiveTo analyze the pressure change and distribution of the intervertebral disc of upper thoracic spine in vertical pressure and 5° flexion, extension, or lateral bending.
MethodsTwelve thoracolumbar spinal specimens were harvested from mini pigs and were divided into 2 groups (n=6). T1, 2, T3, 4, T5, 6, and T7, 8 segments were included in one group, and T2, 3, T4, 5, T6, 7, and T8, 9 segments were included in the other group. The data from both groups represented the complete upper thoracic vertebra data. Biomechanical machine and pressure sensitive film were used to measure the pressure on the vertebral columns under loadings of 100, 150, and 200 N in vertical pressures and 5° flexion, extension, or lateral bending. The pressure change of each intervertebral disc under different loads and in different movement conditions was analyzed.
ResultsIn flexion, the anterior annulus pressure of the upper thoracic vertebra increased (P < 0.05), whereas the posterior annulus pressure showed no significant change (P > 0.05) or an increasing trend (P < 0.05). In extension, the anterior annulus pressure of the upper thoracic vertebra decreased (P < 0.05), whereas the posterior annulus pressure decreased (P < 0.05) or had no obvious change (P > 0.05). In lateral bending, the pressure on the concave side of the annulus increased significantly (P < 0.05).
ConclusionThe upper thoracic vertebra has unique biomechanical characteristics under different loadings; moreover, the posterior vertebral structure plays an important role in the movement of the upper thoracic vertebral segment and pressure distribution. In lateral bending of the upper thoracic vertebra, the concave side pressure will increase significantly, which suggests that asymmetrical force is an important cause of scoliosis progression. Gravity plays an important role in the progression of scoliosis.
ObjectiveTo investigate the short-term effectiveness of calcaneal lateral displacement osteotomy with lateral ligament repair in the treatment of Takakura stage Ⅱ varus-type ankle arthritis. MethodsA retrospective analysis was performed on the clinical data of 13 patients with Takakura stage Ⅱ varus-type ankle arthritis treated with calcaneal lateral displacement osteotomy with lateral ligament repair between January 2016 and December 2020. There were 6 males and 7 females aged 31-65 years, with an average age of 53.6 years. The preoperative tibial-ankle surface angle (TASA) was (88.13±1.01)°, medial distal tibial angle (MDTA) was (86.36±1.49)°, tibial talar surface angle (TTSA) was (6.03±1.63)°, talar tilting angle (TTA) was (81.95±2.15)°, and tibiocalcaneal axis angle (TCAA) was (?5.74±6.81)°. The preoperative American Orthopedic Foot and Ankle Society (AOFAS) score was 56.3±7.1 and the pain visual analogue scale (VAS) score was 3.7±0.5. AOFAS scores, VAS scores, TTSA, TTA, and TCAA were compared between pre- and post-operatively. Results All 13 patients were followed up 14-41 months, with an average of 28.7 months. The osteotomies healed in all patients. The last follow-up revealed TTA, TTSA, and TCAA to be (88.27±1.19)°, (?0.13±1.37)°, and (2.09±5.10)° respectively, the AOFAS score was 84.3±4.2 and the VAS score was 0.7±0.5, all showing significant improvement when compared to preoperative values (P<0.05). Conclusion For patients with Takakura stage Ⅱ varus-type ankle arthritis, calcaneal lateral displacement osteotomy with lateral ligament repair can correct the lower limb force line, regain ankle stability, and achieving good short-term effectiveness.
The integral and individual-scale wavelet entropy of electroencephalogram (EEG) were employed to investigate the information complexity in EEG and to explore the dynamic mechanism of child absence epilepsy (CAE). The digital EEG signals were collected from patients with CAE and normal controls. Time-frequency features were extracted by continuous wavelet transformation. Individual scale power spectrum characteristics were represented by wavelet-transform. The integral and individual-scale wavelet entropy of EEG were computed on the basis of individual scale power spectrum. The evolutions of wavelet entropy across ictal EEG of CAE were investigated and compared with normal controls. The integral wavelet entropy of ictal EEG is lower than inter-ictal EEG for CAE, and it also lower than normal controls. The individual-scale wavelet entropies of 12th scale (centered at 3 Hz) of ictal EEG in CAE was significantly higher than normal controls. The individual-scale wavelet entropies for α band (centered at 10 Hz) of ictal EEG in CAE were much lower than normal controls. The integral wavelet entropy of EEG can be considered as a quantitative parameter of complexity for EEG signals. The complexity of ictal EEG for CAE is obviously declined in CAE. The wavelet entropies declined could become quantitative electrophysiological parameters for epileptic seizures, and it also could provide a theoretical basis for the study of neuromodulation techniques in epileptic seizures.
ObjectiveTo systematically review the unfavorable treatment outcome of multidrug-resistant tuberculosis in China. MethodsCNKI, WanFang Data, CBM, PubMed, EMbase, and Web of Science databases were electronically searched to collect studies that reported unfavorable treatment outcomes of multidrug-resistant tuberculosis in China from inception to April 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was then performed by using Stata 12.0 software. ResultsA total of 11 studies involving 4 465 patients were included. The results of meta-analysis showed that the overall rate of treatment success was 62% (95%CI 55% to 70%), the rate of treatment failure was 19% (95%CI 12% to 26%), the rate of default was 7% (95%CI 4% to 10%), the rate of mortality was 6% (95%CI 4% to 8%) and the rate of unfavorable treatment outcome was 25% (95%CI 19% to 32%). ConclusionsCurrent evidence shows that the treatment failure rate of multidrug-resistant tuberculosis in China is slightly high. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
ObjectiveTo evaluate the effectiveness of liquid wound dressing in the treatment of chronic ulcer wounds.
MethodsBetween January 2014 and October 2015, 84 patients with chronic ulcer wounds were included and divided into 2 groups randomly. The chronic ulcer wounds were covered with liquid wound dressing in the treatment group (n=44) and were managed with iodophor in the control group (n=40). There was no significant difference in age, gender, causes, location, wound area, and disease duration between 2 groups (P > 0.05). The frequency of dress changing, effective rate of treatment, wound healing time, wound healing rate at 5, 10, and 20 days, positive rate of bacteria culture at 1, 5, and 10 days, and the rate of side effect were recorded and compared between 2 groups. Vancouver scar scale was used to evaluate scar formation.
ResultsThe effective rate of the treatment group (100%) was significantly higher than that of the control group (85%) (P=0.009). The frequency of dress changing in the treatment group[(11.36±3.40) times] was significantly lower than that in the control group[(16.94±4.51) times] (t=-6.231, P=0.000). The wound healing rates at 5, 10, and 20 days were significantly increased (P < 0.05) and the wound healing time was significantly decreased (t=-6.627, P=0.000) in the treatment group when compared with the control group. The positive rates of bacteria culture at 5 and 10 days in the treatment group were significantly lower than those in the control group (χ2=12.313, P=0.000; P=0.005), but no significant difference was found at 1 day (χ2=0.066, P=0.797). Side effect was observed in 4 cases of the control group. Vancouver scar scale score was 8.59±1.32 in the treatment group and was 9.85±1.65 in the control group, showing significant difference (t=-3.752, P=0.000).
ConclusionThe application of the liquid wound dressing in the treatment of chronic ulcer wound can improve the wound healing rate, shorten the healing time and decrease the frequency of dress change, which could promote the wound healing process.
ObjectiveTo evaluate the efficacy, safety, and long-term recurrence rate of thoracoscopic bullae resection combined with parietal pleurectomy or pleural abrasion for the treatment of spontaneous pneumothorax. MethodsRelevant literatures were searched in PubMed, Web of Science, EMbase, The Cochrane Library, CNKI, Wanfang and VIP databases from the establishment of each database to February 1, 2025. According to the inclusion and exclusion criteria, the literatures were screened. Meta-analysis was conducted using Review Manager 5.3 software, and the quality of the literatures was evaluated using the Cochrane Bias Risk Assessment Tool and the NOS scale. ResultsA total of 23 articles were included, including 6 randomized controlled studies and 17 retrospective cohort studies, with NOS scores≥7. A total of 3 296 patients were enrolled, including 1 245 in the parietal pleurectomy group and 2 051 in the pleural abrasion group. The meta-analysis results showed that the pleural abrasion group had shorter operation time [MD=19.68, 95%CI (14.12-25.25)], less intraoperative blood loss [MD=11.31, 95%CI (4.20-18.41)], lower postoperative pain score [MD=0.48, 95%CI (0.04-0.91)], lower total postoperative drainage volume [MD=44.31, 95%CI (11.92-76.71)], shorter postoperative drainage time [MD=0.32, 95%CI (0.03-0.60)], and shorter hospital stay [MD=0.40, 95%CI (0.23-0.57)] compared with the parietal pleurectomy group, and the differences were statistically significant (P<0.05). In terms of safety, the parietal pleurectomy group increased the incidence of postoperative pulmonary hemorrhage [OR=3.99, 95%CI (1.49-10.65), P<0.05], but there were no statistically significant differences in the incidence of postoperative atelectasis, pneumothorax leakage and pulmonary infection (P>0.05). In addition, the parietal pleurectomy group could effectively reduce the long-term recurrence rate of patients [OR=0.48, 95%CI (0.36-0.64)], and the difference was statistically significant (P<0.05). ConclusionDecortication inevitably imposes a greater perioperative burden on patients with spontaneous pneumothorax and pulmonary bullae, yet it effectively reduces the risk of postoperative recurrence. While both surgical approaches exhibit similar safety profiles, parietal pleurectomy may elevate the risk of postoperative pulmonary hemorrhage. Therefore, the optimal treatment strategy should be determined based on individual patient characteristics.
