Zhonghua yi xue za zhi
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Zhonghua yi xue za zhi · Jun 2018
[Similar coronal curvature may not represent the same 3-dimensional deformity in adolescent idiopathic scoliosis: a matched-pair study using EOS imaging system].
Objective: To analyze the preoperative axial plane and the surgical outcomes of the Lenke type 1A patients with adolescent idiopathic scoliosis (AIS) whose coronal curve type was matched but thoracic kyphosis (TK) was different. Methods: This study retrospectively reviewed a series of Lenke type 1A female AIS patients who underwent corrective surgery in the Department of Spine Surgery of Nanjing Drum Tower Hospital from May to August 2017. After matched with the Cobb angle of the main thoracic curve, the apical vertebral, the vertebra number included in the curve, the lumber modifier in the Lenke classification and Risser sign, 12 pairs of AIS patients, whose coronal curve was matched but thoracic kyphosis was different, were included in this study. ⋯ The lumbar Cobb angle correction rate was significantly greater in patients with thoracic and lumbar curve rotating in the same direction than that in the opposite direction (81.1% vs 61.9%, t=4.24, P=0.005). Conclusions: It indicated that when the coronal deformity is matched, the MTR of the patients with thoracic hypokyphosis is significantly larger than that in the patients with normal thoracic kyphosis. The direction of the thoracic and lumbar curve rotation is required to be well concerned in the preoperative surgical planning.
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Zhonghua yi xue za zhi · May 2018
[Influence of gender, age and season on thyroid hormone reference interval].
Objective: Using clinical "big data" , to investigate the factors that affect the levels of thyroid hormones, and to explore the partitioning criteria for reference intervals (RI) of these hormones. Methods: An observation study was conducted. Information of 107 107 individuals undergoing routine physical examination in Peking Union Medical College Hospital from September 1(st,) 2013 to August 31(st,) 2016 was collected, thyroid hormone of these subjects were detected. ⋯ Seasons significantly affect the serum TSH level, the peak value is observed in winter. There are obviously differences between "rough" RIs and manufacture recommended RIs. Each laboratory should establish reference intervals for thyroid hormones on the premise of appropriate grouping.
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Zhonghua yi xue za zhi · May 2018
[Quantitative analysis of emphysema and air trapping at inspiratory and expiratory phase multi-slice spiral CT scan in smokers: correlation with pulmonary function test].
Objective: To quantify emphysema and air trapping at inspiratory and expiratory phase multi-slice spiral CT(MSCT) scanning in smokers without respiratory symptoms, and analyze the correlation between the CT quantifiable parameters and lung function parameters. Methods: A total of 72 smokers, who underwent medical examinations from September 2013 to September 2016 in Changzheng Hospital were enrolled in this research and were divided into two groups: 24 smokers with COPD and 48 smokers without COPD. Besides, thirty-nine non-smokers with normal pulmonary function were enrolled as the controls. ⋯ And P(15-IN) positively correlated with DLCO/VA(r=0.53, P=0.01). Conclusions: Smokers emphysema and air trapping can be effectively evaluated by double phase MSCT. Moreover, two of the CT quantifiable parameters, LAA%(-950) and P(15-IN), are highly sensitive to changes in pulmonary function.
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Zhonghua yi xue za zhi · May 2018
[Effects of Scoliosis Research Society-Schwab grade Ⅳ osteotomy for post-traumatic thoracolumbar kyphosis].
Objective: To evaluate the effectiveness of Scoliosis Research Society (SRS)-Schwab grade Ⅳ osteotomy in the treatment of post-traumatic thoracolumbar kyphosis (PTK). Methods: From October 2012 to January 2015, a total of 31 patients [12 males, 19 females, mean age (43±10) years] with symptomatic PTK undergoing SRS-Schwab grade Ⅳ osteotomy in Nanjing Drum Tower Hospital were retrospectively reviewed. Radiographic changes were evaluated with preoperative, postoperative and follow-up X-ray. ⋯ Radiographic evaluation showed solid bony fusion. No instrument-related complication was observed during the follow up. Conclusions: The SRS-Schwab grade Ⅳ osteotomy brings satisfactory sagittal alignment and good clinical outcomes in patients with PTK.
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Zhonghua yi xue za zhi · May 2018
[Impacts of different methods in laryngeal mask airway positioning on the airway management of elderly patients with general anesthesia].
Objective: By observing the clinical effect of ultrasound, fiberoptic bronchoscopy and traditional standard in positioning the general anesthesia of laryngeal mask ventilation in elderly patients, the superiority of laryngeal mask positioning with visualization technique of ultrasound and fiberoptic bronchoscope on airway management in elderly patients with general anesthesia was analyzed. Methods: One hundred and twenty cases of elderly patients with general anesthesia of laryngeal mask ventilation from the People's Hospital of Yuyao city from October 2016 to October 2017 were selected and randomly divided into 3 groups(n=40)according to American Society of Anesthesiologists (ASA) grading criteria Ⅰ-Ⅲ. Group A: traditional standard positioning laryngeal mask group. ⋯ The lowest laryngeal mask intralaryngeal pressure for ventilation in group B and C was (35.39±4.67) cmH(2)O and (32.61±3.22) cmH(2)O, lower than that in group A of (39.30 ± 5.93) cmH(2)O, the intralaryngeal pressure was 60 cmH(2)O, and the airway seal pressure was (25.82±4.48) cmH(2)O and (28.34±6.99) cmH(2)O, higher than that in group A of (22.45±4.98) cmH(2)O, which was significantly different (F=18.200, 9.720, P<0.05). Conclusions: In elderly patients with general anesthesia, it is feasible to manage the airway by ultrasound or fiberoptic bronchoscopy with laryngeal mask. Ultrasound positioning laryngeal mask improves the accuracy of the intraoperative ventilation, and reduces the incidence of postoperative airway related complications.