OBJECTIVE The purpose of this study was to find the best material for valvular wrapping operation of deep vein of lower limb and to study the diagnostic value of colored Ultrasonic-Doppler for valvular incompetency of the deep vein and the function of the popliteal valve. METHODS Strips of autogenous saphenous vein, autogenous fascia lata and pieces of polytetrafluroethylene artificial vessel were used respectively as the wrapping material for narrowing the valve in 30 dogs. The results of three different wrapping material were obtained by colored Ultrasonic-Doppler and transpopliteal venography in 78 patients. The hemokinetics of the popliteal valve was examined in 20 normal persons. RESULTS In the saphenous vein and fascia lata groups, diffuse fibrosis and marked narrowing of the femoral vein were found, while in the group of artificial vein graft, the graft was intact without prominent fibrosis and narrowing of the vein. In comparing with the result of venography, the accuracy of diagnosis by colored Ultrasonic-Doppler was 91.86%. The femoral and popliteal venous valves closed at the same time when holding the breath, but the popliteal venous valve opened more widely than the femoral venous valve when the calf muscles of the leg contracted. CONCLUSION It was suggested that the graft was the best material for valvular wrapping operation, and colored Ultrasonic-Doppler was an important and non-invasive method for the diagnosis of incompetency of deep vein. The popliteal venous valve was the important barrier for protection of the function of deep vein.
Objective To evaluate the clinical appliance and significance of the technique of anorectal manometry. Methdos Different ways of anorectal manometry, domain of its appliance and its clinical appliance was summarized and reviewed. Results The technique of anorectal manometry not only has important value on the study of analrectal pathology and physiology, but also can be associated with other examinations to manage biofeedback therapy, diagnose all kinds of anorectal diseases and evaluate anorectal function. Conclusion Anorectal manometry is a safe, simple, harmless and impersonal examination technique. It is necessary in the examination of analrectal function, in the diagnosis and treatment of anolrectal diseases.
ObjectiveTo investigate the establishment of a risk nomogram model for predicting vagus excitatory response in patients with functional epilepsy after radiofrequency thermocoagulation.MethodsA total of 106 patients with epilepsy admitted to the neurosurgery department of our hospital from January 2016 to June 2020 were selected and divided into the Vagus excitatory response (VER) group and the non-VER group according to their occurrence or absence. Logistic regression analysis was used to screen out the risk factors of VER during SEEG-guided Percutaneous radiofrequency thermocoagulation (PRFT) in patients with functional epilepsy, and R software was used to establish a histogram model affecting VER in SEEG-guided PRFT. Bootstrap method was used for internal verification. C-index, correction curve and ROC curve were used to evaluate the prediction ability of the model.ResultsLogistic regression analysis showed that age [OR=0.235, 95%CI (0.564, 3.076)], preoperative fugl-meyer score [OR=4.356, 95%CI (1.537, 6.621)], depression [OR=0.995, 95%CI (1.068, 7.404)], and lesion range [OR=1.512, 95%CI (0.073, 3.453)] were independent risk factors for the occurrence of VER in PRFT under the guidance of SEEG (P<0.05), and were highly correlated with the occurrence of VER in PRFT. Based on the above six indicators, a SEEG-guided colograph model of VER risk in PRFT was established, and the model was validated internally. The results showed that the C-index of the modeling set and validation set were 0.779 [95%CI (0.689, 0.869)] and 0.782 [95%CI (0.692, 0.872)], respectively. The calibration curves of the two groups fit well with the standard curves. The areas under the ROC curve (AUC) of the two groups were 0.779 and 0.782 respectively, which proved that the model had good prediction accuracy.ConclusionFor patients with functional epilepsy requiring seeg-guided PRFT therapy, age, preoperative Fugl-meyer score, depression and lesion range should be taken into full consideration to comprehensively assess the incidence of VER, and early intervention measures should be taken to reduce and reduce the incidence, which has good clinical application value.
OBJECTIVE: To study the reconstructional method and effect of shoulder joint function in the older obstetrical palsy with medial rotation contracture deformity. METHODS: From April 1996 to July 1999, 7 patients of older obstetrical palsy were adopted in this study. Among them, there were 5 males and 2 females, aged from 13 to 21 years old. No previous operation history and the main deformity was medial rotation contracture of shoulder. During operation, these patients were treated with "Z"-shape elongation of the tendon of subscapular muscle, transfer of the tendons of latissimus dorsi and teres major muscle to the tendons of supraspinous and infraspinous muscles. RESULTS: Followed up for 6 to 44 months(averaged 19 months), the Gilbert grading and Mallet scoring were 1.57, 7.57 preoperatively versus 3.45, 10.86 postoperatively, the abduction and external rotation of the shoulder joints recovered obviously. CONCLUSION: It is an effective operation for the older obstetrical palsy with medial rotation contracture of shoulder.
Developmental and epileptic encephalopathy (DEE) is a group of diseases that severely affects the neurological development of children, characterized by frequent seizures and significant neurodevelopmental impairments. These diseases not only impact the quality of life of affected children but also impose a heavy burden on families and society. In recent years, the development of brain network theory has provided a new perspective on understanding the pathological mechanisms of DEE, especially the role of structural and functional brain networks in the process of epilepsy. This review systematically summarized the research progress of structural and functional brain networks in DEE, highlighted their importance in seizure activity, disease progression, and prognosis evaluation.
Objective To evaluate the effect of tendon transfer on reconstructing the extension of wrist, thumb and digit after irreversible radial nerve injury. Methods From January 1987 to February 2005, 25 cases of irreversible radial nerve injury were treated with Riordan tendon transfer. Among them there were 19 cases of central radial nerve injury with wrist ,thumb and digit extension dysfunction and 6 cases of deep branch of radial nerve injury with digit and thumbextension dysfunction. The muscle strength of wrist and digit extension ranged from grade 0 to grade Ⅰ. Tendon transfer was done 4 months to 8 years after their injuries. Results Twenty-three cases were followed up for3 to 60 months. According to the standard established by Chen Desong, 19 cases (82.6%) showed excellent and good results. Fair result was showed in 2 cases and poor result was showed in 2 cases. Conclusion Riordan tendon transfer should be the first choice of treating irreversible radial nerve injury.
OBJECTIVE: To evaluate the results of limb function and the methods of bone and soft tissue reconstruction of patients treated with allografting. METHODS: From May 1992 to January 1999, 90 patients suffered from bone malignant tumor were treated with allografting in different methods of internal fixations. The average follow-up was 37.5 months. The limb postoperative function, complications related to different surgical methods were compared according to Enneking evaluation system. RESULTS: Skin necrosis, infection, non-union, fracture of allograft were the main complications which affect patients’ limb postoperative functions. Of the 90 fresh-frozen allografting procedures, the final results of operation showed that hip joints and knee joints were better than the shoulder joints. More than 80% of the patients treated with interlocked intramedullary nail and allograft-prosthesis combination led to an over-all result that was excellent and good. Interlocked intermedullary nail was of recommended method of internal fixation. Early exercises of operative limbs could promote function recovery. CONCLUSION: Using of interlocked intramedullary nail and allograft-prosthesis combination are of recommended operation method and can be applied with better results, and early exercises of operative limbs will lead to better functions.
In order to solve the difficult problems of repair and reconstruction for severe deep burns with compound tissue defects of upper limb, 26 cases were treated with transplantation of compound tissue flap, vascularized by anastomosis of blood vessel or by vascular pedicle. Several kinds of reparative and reconstructive procedure could be performed simultaneously. Not only the tissue defect was repaired, but also the upper limb function was reconstructed in one stage operation. Owing to the presence of abundant vascular supply from the vascularized compound tissue and primarily closing the wounds, the anti-infection potency was high, then it was suitable for such conditions as fresh severe deep burn with infection and compound tissue defects. As a result, this technique provided the best chance to save upper limb from amputation. The duration required for treatment could be markedly shortened. All the cases successed. The long-term functional recovery was satisfactory. This method provided the possibility to solve effectively the difficult problem dealing with the severe deep burns with compound tissue defects of upper limb.
Objective To observe and study the effect of neuromuscular exercise (NEMEX) on pain and physical function in patients with knee osteoarthritis (KOA). Methods From December 2016 to December 2017, a total of 70 participants with degenerative KOA were randomly divided into the control group and the observation group, with 35 participants in each group. The participants in the observation group received 8-weeks NEMEX, and the ones in the control group received 8-week quadriceps strengthening. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale and the WOMAC physical functional subscale were used to measure pain and physical function before treatment and after 1 week, 2 weeks, 4 weeks, and 8 weeks of treatment. Results The WOMAC pain scores of participants before treatment and after 1 week, 2 weeks, 4 weeks, and 8 weeks of treatment were 24.2±10.0, 23.4±9.1, 18.9±8.2, 15.0±6.3, 15.0±7.0, respectively in the observation group, and 25.6±9.8, 24.1±9.2, 20.2±8.8, 15.2±6.0, 11.4±5.3, respectively in the control group. After 1 week of treatment, neither group showed a significant change in pain than pretreatment (P>0.05), but after 2, 4, 8 weeks of treatment, both groups showed significant improvements in pain (P<0.05). There was no significant between-group difference in pain before treatment or after 1 week, 2 weeks, and 4 weeks of treatment (P>0.05), but after 8 weeks of treatment, statistically significant difference in WOMAC pain score was found between the two groups (t=2.439, P<0.05). The WOMAC physical function scores of participants before treatment and after 1 week, 2 weeks, 4 weeks, and 8 weeks of treatment were 94.3±31.0, 81.8±28.3, 68.9±22.1, 34.0±15.1, 22.0±8.0, respectively in the observation group, and 92.7±31.8, 82.6±29.3, 75.2±22.9, 52.2±20.0, 43.4±18.2 respectively in the control group. After 1 week, 2 weeks, 4 weeks and 8 weeks of treatment, both groups showed significant changes in WOMAC physical function scores than pretreatment (P<0.05). There was no statistically significant between-group difference before treatment or after 1, 2 weeks of treatment in physical function (P>0.05). The functional improvements in the observation group were significantly better than those in the control group after 4 and 8 weeks of treatment, and the differences were statistically significant (t=–4.287, –6.355; P<0.05). Conclusion NEMEX and quadriceps strengthening have similar effects in relieve pain in patients with KOA. And both exercises can effectively improve the physical function, and NEMEX is better than quadriceps strengthening on physical function improvement in patients with KOA.
Atrial functional mitral regurgitation has been referred to patients with atrial fibrillation related functional mitral regurgitation without left ventricular dysfunction and it has nowadays received remarked attention in structural heart disease field. Significant dilation of mitral annulus and left atrium, insufficient leaflet remodeling, iatrogenic leaflet tethering, reduced annular contractility and increased valve stress by flattened saddle shape of the annulus might be important triggers of atrial functional mitral regurgitation. Recently, several studies indicated that transcatheter edge-to-edge mitral valve repair could be an effective strategy for atrial functional mitral regurgitation. In this review, the definition, mechanism together with efficacy and safety of transcatheter edge-to-edge mitral valve repair in atrial functional mitral regurgitation are discussed.