Is it necessary to place screws in the intervening vertebrae in two-level anterior cervical discectomy with fusion and plating?

ObjectiveThe clinical outcomes, radiological parameters, complication rate and the cost of implants in two-level ACDF with and without screws in the intervening segment were compared.MethodsA retrospective study of 68 patients who underwent 2-level ACDF from January 2014 to June 2016 was performed. The patients were divided into two groups: ACDF with screws in the intervening vertebra and those without screws in the intervening vertebra. Perioperative factors, clinical outcomes, postoperative complications, radiological parameters, and cost of the implants were evaluated in both groups.ResultsNo statistical differences in clinical outcomes, operative blood loss, hospital stay, restoration of cervical lordosis or segment height, postoperative complications, and fusion rate were found between the ACDF (middle vertebra with screw) and ACDF (middle vertebra without screw) groups (P > 0.05). But the operative time of added screw placement and cost of implants in the ACDF (middle vertebra without screw) group were significantly less than the ACDF (middle vertebra with screw) group (P < 0.05).ConclusionTwo kinds of screw placement with ACDF were found to be similar in terms of clinical outcomes. However, ACDF (middle vertebra without screw) was found to be superior to ACDF (middle vertebra with screw) in terms of the screw placement time and cost of implants.     

针刺华佗夹脊穴和督脉穴对强直性脊柱炎患者血清中HMGB1和β-CTX水平及病情活动度的影响

目的:探讨与分析针刺华佗夹脊穴和督脉穴对强直性脊柱炎患者血清中HMGB1和β-CTX水平以及病情活动度的影响。方法:抽取2015年7月—2018年7月本院收治的100例确诊为强直性脊柱炎的患者,随机分为2组,对照组采用柳氮磺胺吡啶片口服治疗,研究组采用针刺督脉穴和华佗夹脊穴的方式进行治疗,每10天为1个疗程,3个疗程后比较两组患者治疗前后血清中HMGB1和β-CTX水平以及病情活动度的改善情况。结果:两组患者的病情活动度比较无明显差异(P>0.05),而接受不同治疗后,两组患者的病情活动度均有一定改善,并且研究组患者病情改善明显优于对照组(P<0.05);治疗前两组患者β-CTX及HMGB1水平无明显区别(P>0.05),治疗后研究组β-CTX及HMGB1水平改善情况显著优于对照组(P<0.05)。结论:针刺华佗夹脊穴和督脉穴能够有效改善患者血清中HMGB1和β-CTX水平,较好改善患者的病情活动度,值得推广使用。     

胃癌患者免疫功能及炎症水平的变化与腹腔镜术后发生医院感染的关系

目的探讨胃癌患者免疫功能及炎症水平的变化与腹腔镜手术后发生医院感染的关系。方法选取腹腔镜手术治疗胃癌并发术后感染患者70例,同期未感染患者70例。检测感染患者血清中免疫细胞及炎症相关因子水平变化情况。结果感染组患者血清中CD3+、CD4+、CD8+、CD4+/CD8+水平明显低于未感染组(P<0.05);感染组患者血清中CRP和IL-6水平明显高于未感染组(P<0.05)。同时对感染组患者进行分析发现,感染率随CD4+水平下降呈显著上升趋势(P<0.05)。ROC分析显示:血清CRP、IL-6及CD4+对腹腔镜手术治疗胃癌后发生医院感染具有较高的预测诊断价值,ROC-AUC均在0.72以上,敏感度和特异度均高于0.7。结论胃癌患者免疫功能及炎症因子水平的变化与腹腔镜手术后发生医院感染有密切关系,对手术后发生医院感染有一定的预测诊断价值,因此,术后应密切关注患者免疫功能及炎症水平的变化,降低感染率。     

抚触护理在病理性黄疸患儿中的应用效果

目的:观察抚触护理在病理性黄疸患儿中的应用效果。方法:选取114例病理性黄疸患儿作为研究对象,按照随机数字表法分为观察组与对照组各57例。对照组实施常规护理,观察组在对照组的基础上实施抚触护理,比较两组黄疸消退时间、护理前后血清总胆红素(TSB)水平、护理总有效率和患儿家长护理满意度。结果:观察组黄疸消退时间为(7.85±1.36)d,明显短于对照组的(9.56±2.85)d,差异有统计学意义(P<0.05);护理后,观察组血清TSB水平低于对照组,差异有统计学意义(P<0.05);观察组护理总有效率为96.5%,明显高于对照组的73.7%,差异有统计学意义(P<0.05);观察组患儿家长满意度为98.2%,明显高于对照组的82.4%,差异有统计学意义(P<0.05)。结论:在常规护理基础上采用抚触护理可缩短病理性黄疸患儿黄疸消退时间,降低血清TSB水平,提高护理总有效率和患儿家长护理满意度,其效果优于单纯常规护理。     

系统化教育管理在控制支气管哮喘病情中的作用研究

目的评价支气管哮喘患者进行系统教育管理的效果。方法将深圳市西丽人民医院2010年1月至2012年6月收治的137例支气管哮喘患者依据随机数字表法分为两组:试验组(63例)接受系统化教育管理,对照组(74例)未经过系统教育管理。对两组患者进行问卷调查,了解其对哮喘的认知水平、用药情况和病情控制水平等,并与对照组结果进行比较。结果试验组哮喘患者在哮喘慢性炎症本质、给药方式、有效药物、能被控制的知晓情况率均高于对照组,差异有统计学意义(P<0.05);试验组哮喘患者在哮喘症状、日常活动受限、急诊入院以及使用短效β2激动剂发生率均低于对照组,差异有统计学意义(P<0.05);治疗管理后两组哮喘症状、心理情绪、避免危险因素、对疾病的担心、危险因素反应比较差异有统计学意义(P<0.05),且试验组高于对照组(P<0.05)。结论哮喘系统教育管理提高了患者对哮喘的认知程度,可指导患者自我监测、自我管理,促进患者的规范治疗,提高哮喘患者的生命质量,从而提高临床控制水平。     

Linear Versus Non-Linear Dose-Response Relationship Between Prenatal Alcohol Exposure and Meconium Concentration of Nine Different Fatty Acid Ethyl Esters

Presence of individual fatty acid ethyl esters (FAEEs) in meconium is considered to be a reliable biomarker of prenatal alcohol exposure, and their concentration has been found to be linearly associated with poor postnatal development, supporting the widely extended idea that ethanol is a non-threshold teratogen. However, a growing number of epidemiological studies have consistently found a lack of adverse short- and long-term fetal outcomes at low exposure levels. We therefore aimed to investigate the relationship between the concentration of individual FAEEs and prenatal alcohol exposure in meconium samples collected within the first 6 to 12?h after birth from 182 babies born to abstainer mothers and from 54 babies born to women who self-reported either light or moderate alcohol ingestion in the second or third trimester of pregnancy. In most cases, the individual FAEE concentrations were negligible and not significantly different (P >0.05) between exposed and control babies. The concentrations appeared to increase linearly with the dose only in the few babies born to mothers who reported >3 drinks/week. These results provide evidence that the correlation between prenatal alcohol exposure and individual FAEE concentrations in meconium is non-linear shape, with a threshold probably at 3 drinks/week.