BACKGROUND Patients who undergo orthopedic procedures are often given excess opioid medication.Understanding the relationship between pain and opioid consumption following total hip arthroplasty(THA)is key to creating...BACKGROUND Patients who undergo orthopedic procedures are often given excess opioid medication.Understanding the relationship between pain and opioid consumption following total hip arthroplasty(THA)is key to creating safe and effective opioid prescribing guidelines.AIM To evaluate the association between the quantity of opioid consumption in relation to pain scores both pre-and postoperatively in patients undergoing primary THA.METHODS We retrospectively reviewed patients who underwent primary THA from November 2018-May 2019 and answered both the visual analog scale(VAS)pain and opioid medication questionnaires pre-and postoperatively.Both surveys were delivered daily for 7-days before surgery through the first 30 postoperative days.Survey results were divided into preoperative,postoperative days 1-7,postoperative days 8-14,and postoperative days 15-30 for analysis.Mean opioid pill consumption and VAS pain scores in each time period were determined and compared to patients’preoperative status using hierarchical Poisson and linear regressions,respectively.RESULTS There were 105 patients included.Mean VAS pain scores were the highest preoperatively 7.41±1.72.However,VAS pain scores significantly declined in each successive postoperative category compared to preoperative scores:postoperative day 1-7(5.07±1.79;P<0.001),postoperative day 8-14(3.60±1.64;P<0.001),and postoperative day 15-30(3.15±1.63;P<0.001).Mean opioid pill consumption preoperatively was 0.68±1.29 pills.Compared to preoperative opioid consumption,opioid use was significantly greater between postoperative days 1-7(1.51±1.58;P=0.001)and postoperative days 8-14(1.00±1.27;P=0.043).Opioid consumption declined below preoperative levels between postoperative days 15-30(0.35±0.72;P=0.160)which correlates with a VAS pain score of 3.15.CONCLUSION All patients experienced significant benefit and pain relief from having undergone THA.Average postoperative opioid consumption decreased below preoperative consumption between postoperative days 15-30,which was associated with a VAS pain score of 3.15.These results can be used to appropriately guide opioid prescribing practices and set patient expectations regarding pain management following THA.展开更多
Objective:To explore the application effect of digital intraoral scanning impression technique in oral implant restoration for periodontitis patients and analyze its impact on patients’Visual Analogue Scale(VAS)score...Objective:To explore the application effect of digital intraoral scanning impression technique in oral implant restoration for periodontitis patients and analyze its impact on patients’Visual Analogue Scale(VAS)scores.Methods:A total of 80 periodontitis patients who received implant restoration in our hospital from May 2023 to May 2025 were selected as research subjects.They were randomly divided into an observation group and a control group using a random number table method,with 40 cases in each group.The observation group used the digital intraoral scanning impression technique to obtain impressions,while the control group used the traditional silicone rubber impression technique.The impression-taking time,the number of prostheses try-ins,implant survival rate,periodontal health indicators(probing depth,gingival index,bleeding index),and VAS scores(pain during treatment and comfort after restoration)were compared between the two groups.Results:The observation group was superior to the control group in terms of impression-taking time,the number of prostheses try-ins,and implant survival rate(p<0.05).Six months after restoration,the improvement in periodontal health indicators in the observation group was significantly better than that in the control group(p<0.05).In addition,the pain VAS score of the observation group during treatment was lower than that of the control group,and the comfort VAS score after restoration was higher than that of the control group(p<0.05).Conclusion:Digital intraoral scanning impression technology can effectively enhance the efficiency and success rate of implant restoration in periodontitis patients,improve periodontal health,alleviate patients’discomfort during treatment,and increase post-restoration comfort,demonstrating high clinical application value.展开更多
BACKGROUND Total knee arthroplasty(TKA)is a widely used treatment for advanced knee osteoarthritis;however,the incidence of failures requiring revision surgery is increasing.Identifying the causes of TKA failure and a...BACKGROUND Total knee arthroplasty(TKA)is a widely used treatment for advanced knee osteoarthritis;however,the incidence of failures requiring revision surgery is increasing.Identifying the causes of TKA failure and assessing the outcomes of revision procedures are essential for improving patient care.We hypothesized that infection and aseptic loosening are the primary causes of TKA failure and that revision TKA(rTKA)significantly enhances functional outcomes.AIM To examine the primary causes of TKA failure and evaluate the functional outcomes following rTKA.METHODS This descriptive study was conducted at the Department of Orthopedic Surgery,Civil Hospital,Bahawalpur,from April to September 2024.A total of 118 patients undergoing rTKA for failed primary TKA were included.Data on demographics,causes of failure,and surgical details were collected.Functional outcomes were evaluated using the Knee Society Score and Visual Analog Scale before and six months after surgery.Statistical analysis was performed using SPSS version 25.0,with statistical significance set at P<0.05.RESULTS The leading causes of TKA failure were infection(45.8%),aseptic loosening(44.1%),and periprosthetic fractures(10.2%).The rTKA significantly improved knee function,with the mean Knee Society Score increasing from 39.43±6.18 to 78.91±6.17(P<0.001).Pain levels decreased substantially,with the mean Visual Analog Scale scores reducing from 7.99±1.37 to 1.42±1.17(P<0.001).No significant differences in outcomes were observed between single-stage and two-stage revision procedures.CONCLUSION Infection and aseptic loosening are the predominant causes of TKA failure.The rTKA effectively enhances knee function and alleviates pain,offering significant benefits to patients.展开更多
BACKGROUND Currently,colonoscopy still needs continuous optimization and exploration of novel alternative approaches to enhance the experience of patients during co-lonoscopy.AIM To analyze the efficacy of water infus...BACKGROUND Currently,colonoscopy still needs continuous optimization and exploration of novel alternative approaches to enhance the experience of patients during co-lonoscopy.AIM To analyze the efficacy of water infusion combined with defoamers in colono-scopy.METHODS This study included 97 patients undergoing colonoscopy from January 2024 to June 2024.The participants were categorized into two groups,namely,the control group(n=47),who underwent conventional colonoscopy,and the experimental group(n=50),who received colonoscopy using water injection combined with defoamers.A comparative analysis was then conducted on the disease detection rate(colonic polyps,colonorrhagia,colonic ulcers,colonic mucosal lesions,and others),colonoscopy duration,abdominal pain[visual analog scale(VAS)],Boston bowel preparation scale(BBPS),self-rating anxiety scale(SAS),bowel preparation comfort,complications(intestinal perforation,bleeding,nausea and vomiting,abdominal pain,and abdominal distension),and patient satisfaction.RESULTS The experimental group demonstrated a significantly higher total disease detection rate,BBPS scores,and patient satisfaction compared with the control group.Further,the research group exhibited shorter colonoscopy duration,lower VAS and SAS scores and total complication rate,and better patient comfort and satisfaction.CONCLUSION These results indicate that the combination of water injection and defoamers exhibited an overall better therapeutic effect than conventional colonoscopy,mainly reflected in higher disease detection rate,faster examination ef-ficiency,lower abdominal pain,anxiety,and complication incidences,and significantly better bowel preparation,comfort,and patient satisfaction.展开更多
目的:探讨中药材多元化应用与神经内科后遗症患者长期康复质量的关系,特别关注脑梗塞后肌张力障碍患者的康复效果。方法:研究回顾性地分析了医院神经内科2021年2月—2022年7月期间收治的70例脑梗塞后肌张力障碍患者。其中,35例患者接受...目的:探讨中药材多元化应用与神经内科后遗症患者长期康复质量的关系,特别关注脑梗塞后肌张力障碍患者的康复效果。方法:研究回顾性地分析了医院神经内科2021年2月—2022年7月期间收治的70例脑梗塞后肌张力障碍患者。其中,35例患者接受了常规的现代医学服务流程,被设为对照组;另外35例患者在对照组基础上进一步完善中药材多元化应用方案,被设为观察组。采用Ashworth评分、Fugl-Meyer运动评分、Visual Analog Scale(VAS)和患者健康问卷(PHQ)等工具对患者进行评估,以评估肌肉痉挛严重程度、肢体运动功能、主观感受程度和心理健康状况。结果:观察组在Ashworth评分、VAS评分方面表现出明显高于对照组(P<0.05)。观察组情感问题、焦虑问题、社交功能障碍、身体症状维度评分及PHQ问卷总分均显著低于对照组(P<0.05)。结论:中药材多元化应用与神经内科后遗症患者的长期康复质量密切相关。对脑梗塞后肌张力障碍患者采用中药材多元应用方案,可以显著改善肌肉痉挛的严重程度、肢体运动功能,减轻主观感受程度,并提高患者的心理健康状况。因此,中药材多元化应用在神经内科后遗症患者的康复治疗中具有潜在的临床应用价值。展开更多
BACKGROUND Limited evidence exists regarding the role of enhanced recovery after surgery(ERAS)protocols in optimizing pain management and functional recovery after colorectal cancer(CRC)surgery.AIM To evaluate the imp...BACKGROUND Limited evidence exists regarding the role of enhanced recovery after surgery(ERAS)protocols in optimizing pain management and functional recovery after colorectal cancer(CRC)surgery.AIM To evaluate the impact of ERAS protocols on postoperative pain management and functional recovery in patients undergoing CRC surgery.METHODS A total of 109 patients with CRC admitted to The Third Affiliated Hospital of Jinzhou Medical University between June 2021 and June 2024 were enrolled in this study.They were divided into two groups:A control group(n=50)receiving standard perioperative care and an observation group(n=59)managed under an ERAS protocol.Clinical outcomes,including postoperative pain intensity[assessed using the Visual Analogue Scale(VAS)],functional recovery indicators(time to first ambulation,bowel sound recovery,first anal gas discharge,and first defecation),average sleep duration on postoperative day 3,sleep quality(measured using the Pittsburgh Sleep Quality Index),length of hospitalization,quality of life(evaluated using the Short Form 36 Health Survey),and incidence of postoperative complications(e.g.,surgical site infection,pulmonary infection,abdominal distension/pain,and intestinal obstruction),were systematically compared between the two groups.RESULTS The observation group exhibited significantly lower VAS scores at 72 hours postoperatively,shorter durations of maximum VAS scores,earlier recovery of functional indicators(time to first ambulation,bowel sound recovery,first anal gas discharge,and first defecation),and shorter hospitalization compared with the control group.Additionally,average sleep duration on postoperative day 3 was significantly longer in the observation group.Furthermore,the observation group demonstrated significantly improved sleep quality(lower Pittsburgh Sleep Quality Index scores)and higher quality of life(higher Short Form 36 Health Survey scores across all domains)than both the baseline and control groups.The incidence of total postoperative complications was also significantly lower in the observation group than in the control group.CONCLUSION ERAS protocols are highly effective in relieving postoperative pain,accelerating functional recovery,and improving overall clinical outcomes in patients with CRC undergoing surgery,supporting their broader clinical application.展开更多
目的:干针治疗被广泛应用于各种肌筋膜疼痛综合征,该文旨在系统评价干针治疗膝关节疾病的临床效果。方法:检索PubMed、EBSCO、ScienceDirect、Web of Science、CINAHL、Cochrane Library、中国知网等数据库中发表的文献,选取随机对照试...目的:干针治疗被广泛应用于各种肌筋膜疼痛综合征,该文旨在系统评价干针治疗膝关节疾病的临床效果。方法:检索PubMed、EBSCO、ScienceDirect、Web of Science、CINAHL、Cochrane Library、中国知网等数据库中发表的文献,选取随机对照试验且使用干针作为主要治疗手段,并纳入诊断为膝关节疾病的患者。由2位评估人独立筛选文章,对方法学质量进行评分,并提取数据。主要指标有目测类比评分,次要指标主要有西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、压痛阈值、膝关节活动度和Kujala评分(膝关节功能评分量表)。结果:Meta分析共纳入15项随机对照试验,涉及698例患者。Meta分析结果显示,与非干针治疗组相比,干针治疗组目测类比评分、WOMAC疼痛评分与WOMAC僵硬度评分存在明显优势(MD=-0.63,95%CI:-1.06至-0.19,P=0.005;MD=-0.74,95%CI:-1.32至-0.17,P=0.01;MD=-0.43,95%CI:-0.77至-0.09,P=0.01),WOMAC总评分、WOMAC功能评分、压痛阈值、膝关节活动度、Kujala评分没有明显优势。结论:干针可以有效治疗膝关节疼痛和僵硬度,然而在改善其他膝关节功能障碍方面的临床优势及随访效果证据不足。所以,对于一些年龄较大患有膝关节慢性疼痛或关节僵硬的患者,可以谨慎考虑使用干针治疗。展开更多
文摘BACKGROUND Patients who undergo orthopedic procedures are often given excess opioid medication.Understanding the relationship between pain and opioid consumption following total hip arthroplasty(THA)is key to creating safe and effective opioid prescribing guidelines.AIM To evaluate the association between the quantity of opioid consumption in relation to pain scores both pre-and postoperatively in patients undergoing primary THA.METHODS We retrospectively reviewed patients who underwent primary THA from November 2018-May 2019 and answered both the visual analog scale(VAS)pain and opioid medication questionnaires pre-and postoperatively.Both surveys were delivered daily for 7-days before surgery through the first 30 postoperative days.Survey results were divided into preoperative,postoperative days 1-7,postoperative days 8-14,and postoperative days 15-30 for analysis.Mean opioid pill consumption and VAS pain scores in each time period were determined and compared to patients’preoperative status using hierarchical Poisson and linear regressions,respectively.RESULTS There were 105 patients included.Mean VAS pain scores were the highest preoperatively 7.41±1.72.However,VAS pain scores significantly declined in each successive postoperative category compared to preoperative scores:postoperative day 1-7(5.07±1.79;P<0.001),postoperative day 8-14(3.60±1.64;P<0.001),and postoperative day 15-30(3.15±1.63;P<0.001).Mean opioid pill consumption preoperatively was 0.68±1.29 pills.Compared to preoperative opioid consumption,opioid use was significantly greater between postoperative days 1-7(1.51±1.58;P=0.001)and postoperative days 8-14(1.00±1.27;P=0.043).Opioid consumption declined below preoperative levels between postoperative days 15-30(0.35±0.72;P=0.160)which correlates with a VAS pain score of 3.15.CONCLUSION All patients experienced significant benefit and pain relief from having undergone THA.Average postoperative opioid consumption decreased below preoperative consumption between postoperative days 15-30,which was associated with a VAS pain score of 3.15.These results can be used to appropriately guide opioid prescribing practices and set patient expectations regarding pain management following THA.
文摘Objective:To explore the application effect of digital intraoral scanning impression technique in oral implant restoration for periodontitis patients and analyze its impact on patients’Visual Analogue Scale(VAS)scores.Methods:A total of 80 periodontitis patients who received implant restoration in our hospital from May 2023 to May 2025 were selected as research subjects.They were randomly divided into an observation group and a control group using a random number table method,with 40 cases in each group.The observation group used the digital intraoral scanning impression technique to obtain impressions,while the control group used the traditional silicone rubber impression technique.The impression-taking time,the number of prostheses try-ins,implant survival rate,periodontal health indicators(probing depth,gingival index,bleeding index),and VAS scores(pain during treatment and comfort after restoration)were compared between the two groups.Results:The observation group was superior to the control group in terms of impression-taking time,the number of prostheses try-ins,and implant survival rate(p<0.05).Six months after restoration,the improvement in periodontal health indicators in the observation group was significantly better than that in the control group(p<0.05).In addition,the pain VAS score of the observation group during treatment was lower than that of the control group,and the comfort VAS score after restoration was higher than that of the control group(p<0.05).Conclusion:Digital intraoral scanning impression technology can effectively enhance the efficiency and success rate of implant restoration in periodontitis patients,improve periodontal health,alleviate patients’discomfort during treatment,and increase post-restoration comfort,demonstrating high clinical application value.
文摘BACKGROUND Total knee arthroplasty(TKA)is a widely used treatment for advanced knee osteoarthritis;however,the incidence of failures requiring revision surgery is increasing.Identifying the causes of TKA failure and assessing the outcomes of revision procedures are essential for improving patient care.We hypothesized that infection and aseptic loosening are the primary causes of TKA failure and that revision TKA(rTKA)significantly enhances functional outcomes.AIM To examine the primary causes of TKA failure and evaluate the functional outcomes following rTKA.METHODS This descriptive study was conducted at the Department of Orthopedic Surgery,Civil Hospital,Bahawalpur,from April to September 2024.A total of 118 patients undergoing rTKA for failed primary TKA were included.Data on demographics,causes of failure,and surgical details were collected.Functional outcomes were evaluated using the Knee Society Score and Visual Analog Scale before and six months after surgery.Statistical analysis was performed using SPSS version 25.0,with statistical significance set at P<0.05.RESULTS The leading causes of TKA failure were infection(45.8%),aseptic loosening(44.1%),and periprosthetic fractures(10.2%).The rTKA significantly improved knee function,with the mean Knee Society Score increasing from 39.43±6.18 to 78.91±6.17(P<0.001).Pain levels decreased substantially,with the mean Visual Analog Scale scores reducing from 7.99±1.37 to 1.42±1.17(P<0.001).No significant differences in outcomes were observed between single-stage and two-stage revision procedures.CONCLUSION Infection and aseptic loosening are the predominant causes of TKA failure.The rTKA effectively enhances knee function and alleviates pain,offering significant benefits to patients.
基金Supported by Foshan City Self-Raised Funds Science and Technology Innovation Project,No.2320001007369.
文摘BACKGROUND Currently,colonoscopy still needs continuous optimization and exploration of novel alternative approaches to enhance the experience of patients during co-lonoscopy.AIM To analyze the efficacy of water infusion combined with defoamers in colono-scopy.METHODS This study included 97 patients undergoing colonoscopy from January 2024 to June 2024.The participants were categorized into two groups,namely,the control group(n=47),who underwent conventional colonoscopy,and the experimental group(n=50),who received colonoscopy using water injection combined with defoamers.A comparative analysis was then conducted on the disease detection rate(colonic polyps,colonorrhagia,colonic ulcers,colonic mucosal lesions,and others),colonoscopy duration,abdominal pain[visual analog scale(VAS)],Boston bowel preparation scale(BBPS),self-rating anxiety scale(SAS),bowel preparation comfort,complications(intestinal perforation,bleeding,nausea and vomiting,abdominal pain,and abdominal distension),and patient satisfaction.RESULTS The experimental group demonstrated a significantly higher total disease detection rate,BBPS scores,and patient satisfaction compared with the control group.Further,the research group exhibited shorter colonoscopy duration,lower VAS and SAS scores and total complication rate,and better patient comfort and satisfaction.CONCLUSION These results indicate that the combination of water injection and defoamers exhibited an overall better therapeutic effect than conventional colonoscopy,mainly reflected in higher disease detection rate,faster examination ef-ficiency,lower abdominal pain,anxiety,and complication incidences,and significantly better bowel preparation,comfort,and patient satisfaction.
文摘目的:探讨中药材多元化应用与神经内科后遗症患者长期康复质量的关系,特别关注脑梗塞后肌张力障碍患者的康复效果。方法:研究回顾性地分析了医院神经内科2021年2月—2022年7月期间收治的70例脑梗塞后肌张力障碍患者。其中,35例患者接受了常规的现代医学服务流程,被设为对照组;另外35例患者在对照组基础上进一步完善中药材多元化应用方案,被设为观察组。采用Ashworth评分、Fugl-Meyer运动评分、Visual Analog Scale(VAS)和患者健康问卷(PHQ)等工具对患者进行评估,以评估肌肉痉挛严重程度、肢体运动功能、主观感受程度和心理健康状况。结果:观察组在Ashworth评分、VAS评分方面表现出明显高于对照组(P<0.05)。观察组情感问题、焦虑问题、社交功能障碍、身体症状维度评分及PHQ问卷总分均显著低于对照组(P<0.05)。结论:中药材多元化应用与神经内科后遗症患者的长期康复质量密切相关。对脑梗塞后肌张力障碍患者采用中药材多元应用方案,可以显著改善肌肉痉挛的严重程度、肢体运动功能,减轻主观感受程度,并提高患者的心理健康状况。因此,中药材多元化应用在神经内科后遗症患者的康复治疗中具有潜在的临床应用价值。
文摘BACKGROUND Limited evidence exists regarding the role of enhanced recovery after surgery(ERAS)protocols in optimizing pain management and functional recovery after colorectal cancer(CRC)surgery.AIM To evaluate the impact of ERAS protocols on postoperative pain management and functional recovery in patients undergoing CRC surgery.METHODS A total of 109 patients with CRC admitted to The Third Affiliated Hospital of Jinzhou Medical University between June 2021 and June 2024 were enrolled in this study.They were divided into two groups:A control group(n=50)receiving standard perioperative care and an observation group(n=59)managed under an ERAS protocol.Clinical outcomes,including postoperative pain intensity[assessed using the Visual Analogue Scale(VAS)],functional recovery indicators(time to first ambulation,bowel sound recovery,first anal gas discharge,and first defecation),average sleep duration on postoperative day 3,sleep quality(measured using the Pittsburgh Sleep Quality Index),length of hospitalization,quality of life(evaluated using the Short Form 36 Health Survey),and incidence of postoperative complications(e.g.,surgical site infection,pulmonary infection,abdominal distension/pain,and intestinal obstruction),were systematically compared between the two groups.RESULTS The observation group exhibited significantly lower VAS scores at 72 hours postoperatively,shorter durations of maximum VAS scores,earlier recovery of functional indicators(time to first ambulation,bowel sound recovery,first anal gas discharge,and first defecation),and shorter hospitalization compared with the control group.Additionally,average sleep duration on postoperative day 3 was significantly longer in the observation group.Furthermore,the observation group demonstrated significantly improved sleep quality(lower Pittsburgh Sleep Quality Index scores)and higher quality of life(higher Short Form 36 Health Survey scores across all domains)than both the baseline and control groups.The incidence of total postoperative complications was also significantly lower in the observation group than in the control group.CONCLUSION ERAS protocols are highly effective in relieving postoperative pain,accelerating functional recovery,and improving overall clinical outcomes in patients with CRC undergoing surgery,supporting their broader clinical application.
文摘目的:干针治疗被广泛应用于各种肌筋膜疼痛综合征,该文旨在系统评价干针治疗膝关节疾病的临床效果。方法:检索PubMed、EBSCO、ScienceDirect、Web of Science、CINAHL、Cochrane Library、中国知网等数据库中发表的文献,选取随机对照试验且使用干针作为主要治疗手段,并纳入诊断为膝关节疾病的患者。由2位评估人独立筛选文章,对方法学质量进行评分,并提取数据。主要指标有目测类比评分,次要指标主要有西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分、压痛阈值、膝关节活动度和Kujala评分(膝关节功能评分量表)。结果:Meta分析共纳入15项随机对照试验,涉及698例患者。Meta分析结果显示,与非干针治疗组相比,干针治疗组目测类比评分、WOMAC疼痛评分与WOMAC僵硬度评分存在明显优势(MD=-0.63,95%CI:-1.06至-0.19,P=0.005;MD=-0.74,95%CI:-1.32至-0.17,P=0.01;MD=-0.43,95%CI:-0.77至-0.09,P=0.01),WOMAC总评分、WOMAC功能评分、压痛阈值、膝关节活动度、Kujala评分没有明显优势。结论:干针可以有效治疗膝关节疼痛和僵硬度,然而在改善其他膝关节功能障碍方面的临床优势及随访效果证据不足。所以,对于一些年龄较大患有膝关节慢性疼痛或关节僵硬的患者,可以谨慎考虑使用干针治疗。
