单双侧经皮椎体成形术治疗骨质疏松性椎体压缩性骨折疗效对比

【摘要】 目的 对比分析单双侧经皮椎体成形术治疗骨质疏松性椎体压缩性骨折的临床效果。方法 选取2018 年 5 月至 2020 年 6 月河南省洛阳正骨医院收治的 104 例骨质疏松性椎体压缩性骨折患者作为研究对象, 并按照治疗方法将其分为单侧组与双侧组, 每组 52 例。单侧组患者采用单侧经皮椎体成形术治疗, 双侧组患者采用双侧经皮椎体成形术治疗, 对比两组患者手术时间、视觉模拟评分法 (VAS) 评分、椎体前缘高度、Cobb 角以及并发症发生情况。 结果 单侧组患者手术时间明显短于双侧组 (t = 29.664, P < 0.001); 术后 1 个月, 单侧组患者VAS评分、椎体前缘高度及 Cobb 角与双侧组无明显差异 ( t = 0.312、0.487、0.657, P = 0.756、0.627?0.513); 单侧组患者并发症发生率与双侧组无明显差异 (χ2= 0.343, P = 0.558)。结论 单双侧经皮椎体成形术治疗骨质疏松性椎体压缩性骨折均可取得满意的治疗效果, 但单侧经皮椎体成形术手术时间较短, 操作更简便。     

紫杉醇药物涂层球囊成形术治疗症状性椎动脉开口处狭窄的疗效

目的 探讨紫杉醇药物涂层球囊（P-DCB）成形术治疗症状性椎动脉开口狭窄的安全性和有效性。方法 回顾性分析2017 年12月至2019年6月经P-DCB成形术治疗的43例症状性椎动脉开口处狭窄的临床资料。结果 所有病人均完成介入治疗，成功率为100%。术后即刻狭窄率[（12.03±2.15）%]较术前[（86.32±10.26）%]明显降低（P<0.05）。围手术期发生动脉夹层1例，无其他并发症。随访12~16个月，平均13.5个月；症状改善43例，无变化例，症状改善率为95.3%（41/43）；全部病人接受DSA或CTA随访，随访狭窄率[（16.1±3.12）%]与术后即刻无统计学差异（P>0.05）；5例发生再狭窄，再狭窄率为11.6%。结论 P-DCB成形术治疗椎动脉开口狭窄具有较好的临床疗效。     

Polymethylmethacrylate‐induced nodules of the lips: Clinical presentation and management by intralesional neodymium:YAG laser therapy

The lips are essential part of the beauty and attractiveness of the human face. Lip augmentation has become an increasingly used method to improve appearance. Soft tissue fillers are the most commonly used tools. Permanent fillers, however, have been associated with unwanted side effects after lip augmentation. In the present article the present authors will focus on permanent fillers based on polymethylmethacrylate (PMMA). The present authors provide a short review on PMMA fillers and known associated adverse events. The present authors provide a critical review of treatment options. Illustrated by clinical cases The present authors report our preferred treatment of PMMA nodules on lips by intralesional neodymium:YAG laser and blunt suction cannula with or without minor surgery.     

Apical U-shape splitting technique for undercut areas of the anterior alveolar ridge: a prospective non-randomized controlled study

The aim of this study was to investigate a novel apical U-shape splitting technique for horizontal bone augmentation in undercut areas and to compare its efficacy with that of guided bone regeneration (GBR). This was a prospective non-randomized controlled clinical trial. A total of 36 patients, who presented with a labial undercut that was not able to house a normally inclined implant, underwent the new technique or GBR. Radiographic and clinical data were obtained preoperatively, immediately after surgery, and 12 months after surgery. Pairwise comparisons of changes in ridge width gain, marginal bone loss, and pink aesthetic score were performed; correlations with pristine ridge morphology were investigated. The results showed similar marginal bone loss in the two groups. The overall ridge width gains in the new technique group (2.56 ± 1.92 mm) and GBR group (0.73 ± 1.21 mm) differed significantly (P < 0.05). The pink aesthetic score was higher for the new technique group (11.75 ± 1.22) than for the GBR group (9.25 ± 1.86) (P < 0.01). The morphology of the concavity had different impacts on regeneration in the two groups. The apical U-shape splitting technique, as a safe and effective alternative to GBR, provided a significant increase in bone volume gain where labial fenestration was inevitable during implant placement.     

How to implement guidelines and models of care

In subjects older than 50 years, the presence of clinical risk factors (CRFs) for fractures or a recent fracture is the cornerstone for case finding. In patients who are clinically at high short- and long-term risk of fractures (those with a recent clinical fracture or with multiple CRFs), further assessment with bone mineral density (BMD) measurement using dual-energy absorptiometry (DXA), imaging of the spine, fall risk evaluation and laboratory examination contributes to treatment decisions according to the height and modifiability of fracture risk. Treatment is available with anti-resorptive and anabolic drugs, and from the start of treatment a lifelong strategy is needed to decide about continuous, intermittent, and sequential therapy. Implementation of guidelines requires further initiatives for improving case finding, public awareness about osteoporosis and national policies on reimbursement of assessment and therapy.     

风池穴不同刺法对椎动脉型颈椎病的临床疗效评价

目的:探究风池穴不同刺法对椎动脉型颈椎病的临床疗效。方法:选择2018年4月—2019年1月北京中医药大学东直门医院针灸科门诊就诊的84例椎动脉型颈椎病患者作为研究对象,分为观察组43例、对照组41例。观察组采用短刺法针刺风池穴治疗,对照组采用平补平泻法针刺风池穴治疗,1个疗程后比较两组患者的ESCV、颈椎病症状分级量化表评分以及TCD相关指标,TCD指标观察基底动脉和双侧椎动脉的平均血流速度(Vm)、收缩期血流速度峰值(Vs)、血管搏动指数(PI)和血管阻力指数(RI)的变化。结果:治疗前后两组ESCV、颈椎病症状分级量化表评分比较,差异有统计学意义(P<0.05),且椎动脉、基底动脉的Vs、Vm较治疗前明显减慢,且观察组治疗效果优于对照组(P<0.05)。结论:针刺风池穴治疗椎动脉型颈椎病临床效果显著,且短刺法优于平补平泻法。