In this article,we comment on the article by Oommen et al.Oommen et al provided a comprehensive overview of the management of hip centre restoration in total hip arthroplasty(THA)for childhood hip disorder sequelae.Gi...In this article,we comment on the article by Oommen et al.Oommen et al provided a comprehensive overview of the management of hip centre restoration in total hip arthroplasty(THA)for childhood hip disorder sequelae.Given the developmental disparity in this population,specific preoperative planning is an essential prerequisite for the success of THA procedures.In the review by Oommen et al,assessments of acetabular and femoral anatomic variations were fully described.However,spinal malalignment and stiffness are common in physical and radiological examinations and should be taken into careful consideration when planning surgical procedures.Poor outcomes of THA for patients with comorbid hip and spinopelvic pathologies have been widely reported,especially for hips with childhood disorder sequelae.Therefore,in this editorial,we would like to emphasize the need for a thorough hip-spine evaluation of patients with childhood hip disorder sequelae before THA.展开更多
Adults requiring total hip arthroplasty(THA)for childhood disorder sequelae present with shortening,limp,pain,and altered gait.THA,which can be particularly challenging due to altered anatomy,requires careful planning...Adults requiring total hip arthroplasty(THA)for childhood disorder sequelae present with shortening,limp,pain,and altered gait.THA,which can be particularly challenging due to altered anatomy,requires careful planning,assessment,and computed tomography evaluation.Preoperative templating is essential to establish the appropriate acetabular and femoral size.Information regarding neck length and offset is needed to ensure the proper options are available at THA.Hip centre restoration must be planned preoperatively and achieved intraoperatively with appropriate exposure,identification,and stable fixation with optimum-size components.Identifying the actual acetabular floor is essential as changes include altered anatomy,distortion of the margins and version changes.Proximal femur changes include anatomical variation,decreased canal diameter,cortical thickness,changes in anteversion,and metaphyseal and diaphyseal mismatch.Preoperative assessment should consist of limb assessment for variations due to prior surgical procedures.Evaluation of the shortening pattern with the relationship of the lesser trochanter to the teardrop would help identify and plan for subtrochanteric shortening osteotomy,especially in high-riding hips.The surgical approach must ensure adequate exposure and soft tissue release to achieve restoration of the anatomical hip centre.The femoral components may require modularity to enable restoration of anteversion and optimum fixation.展开更多
Hip arthroplasty in patients with a history of paediatric hip disorders presents a significant challenge for orthopaedic surgeons.These patients are typically younger and have greater functional demands.Therefore,achi...Hip arthroplasty in patients with a history of paediatric hip disorders presents a significant challenge for orthopaedic surgeons.These patients are typically younger and have greater functional demands.Therefore,achieving optimal biomechanical conditions is crucial,involving placement of the acetabulum at the ideal centre of rotation and securing a stable femoral component with good offset to preserve abductor muscle function and restore leg length.The altered anatomy in these cases makes total hip arthroplasty more complex,necessitating thorough preoperative imaging and an individualised surgical approach.Various techniques may be employed to optimise biomechanical outcomes.We propose a modified lateral hip approach,offering exceptional visualisation of the acetabulum and femur while preserving the continuity of the abductor muscles without requiring trochanteric osteotomy.To achieve the most biomechanically advantageous acetabular position,cotyloplasty is our preferred method.展开更多
Sequelae of Pelvic Inflammatory Diseases (SPID) is a common and frequent disease in gynecology, which adversely affects women’s reproductive health and quality of life due to its prolonged course. In recent years, tr...Sequelae of Pelvic Inflammatory Diseases (SPID) is a common and frequent disease in gynecology, which adversely affects women’s reproductive health and quality of life due to its prolonged course. In recent years, traditional Chinese medicine (TCM) in China has gradually shown its clinical advantages in the treatment of SPID. Therefore, the present review summarizes the etiology and pathogenesis of SPID, the evidence typology, and the clinical application effects of moxibustion, herbal retention enema, acupoint compresses, external application of traditional Chinese medicine, auricular pressure beans, tuina massage, traditional Chinese medicine gongfu, and other commonly used Chinese medicine nursing techniques, with the aim of providing references and experiences for the subsequent related studies.展开更多
The research progress of brain-derived neurotrophic factor (BDNF) in the treatment of sequelae of stroke is an important topic. Stroke is among the diseases with the highest mortality and disability rates among the el...The research progress of brain-derived neurotrophic factor (BDNF) in the treatment of sequelae of stroke is an important topic. Stroke is among the diseases with the highest mortality and disability rates among the elderly in China. BDNF plays an important role in the development and functional maintenance of the nervous system. In recent years, the application value of BDNF in rehabilitation therapy has gradually received attention. This study has adopted a systematic literature review method, searched Chinese and English databases, screened relevant studies, and conducted data extraction and quality evaluation. This review systematically introduced the research progress of BDNF in the correlation with post-stroke sequelae, with special attention to its application in post-stroke depression, motor dysfunction, and cognitive dysfunction. The results showed that a decrease in BDNF levels is closely related to the exacerbation of depressive symptoms, limited recovery of motor dysfunction, and the occurrence of cognitive dysfunction. BDNF, as a key neurobiological factor, has shown significant potential in the rehabilitation treatment of stroke. By exploring the potential of BDNF as a therapeutic target to prevent and treat sequelae of ischemic stroke, the current research bottlenecks, and the development trends of future treatment strategies.展开更多
This case report presents a 63-year-old male patient with a history of TB 20 years prior, who developed chronic cor pulmonale, right heart failure, and eventually died. The report emphasizes the serious long-term effe...This case report presents a 63-year-old male patient with a history of TB 20 years prior, who developed chronic cor pulmonale, right heart failure, and eventually died. The report emphasizes the serious long-term effects of post-TB sequelae, highlighting diagnostic challenges, clinical progression, and management strategies. The case report addresses a significant and often overlooked aspect of TB management: the long-term complications following TB treatment, known as post-TB sequelae.展开更多
Introduction: The treatment of panfacial fractures is complex and constitutes a challenge for the maxillofacial surgeon, who, despite therapeutic progress, frequently suffers functional and aesthetic sequelae. This st...Introduction: The treatment of panfacial fractures is complex and constitutes a challenge for the maxillofacial surgeon, who, despite therapeutic progress, frequently suffers functional and aesthetic sequelae. This study aimed to describe the treatment and evaluate the functional and aesthetic sequelae of panfacial fractures in the stomatology and maxillofacial surgery department of the Treichville University Hospital. Materials and Methods: We conducted a retrospective study over a 6 years in the stomatology and maxillofacial surgery department of Treichville University Hospital. Forty-two patients with panfacial fractures were included in the study. Results: Forty-two patients were registered. The average time to osteosynthesis was 12.4 days. Nasotracheal intubation was used most often (88%), and in the majority of cases, mixed osteosynthesis combining a screwed plate and steel wire was performed (64.29%). The “Bottom-up and Outside-in” surgical sequence was the most commonly used (64.29%). All patients had at least one functional and/or cosmetic sequela after treatment. Functional sequelae were dominated by occlusal problems and aesthetic sequelae by nasal deformities. Discussion: Panfacial fractures are characterised by their complexity, presenting maxillo-facial surgeons with a therapeutic and evolutionary challenge. The quality of the initial, often multidisciplinary, management of panfacial fractures is an essential factor in both functional and aesthetic prognosis. Conclusion: The treatment of panfacial fractures, even if well managed, is sometimes a source of sequelae, requiring often complex secondary management.展开更多
Objective:To explore the therapeutic effect of acupoint catgut embedding combined with gingerseparated moxibustion for sequelae of peripheral facial paralysis and whether surface electromyography(sEMG)can be an outcom...Objective:To explore the therapeutic effect of acupoint catgut embedding combined with gingerseparated moxibustion for sequelae of peripheral facial paralysis and whether surface electromyography(sEMG)can be an outcome to evaluate the effect of this disease.Methods:Thirty-five patients with sequelae of peripheral facial paralysis were treated with catgut embedding at the acupoints selected according to their individual symptoms and traditional Chinese medicine(TCM)differentiated syndromes.At the same time,the ginger-separated moxibustion was applied at Yifeng(翳风TE17)and Qianzheng(牵正EX-HN16)of the affected side.The catgut embedding was applied once every 15 days,one time of treatment is of one course,and a total of three courses were given.The moxibustion would be taken after 5 days of catgut embedding each time,once every other day,5 times as one course,a total of 3 courses are given.After treatment,the recovery of facial nerve functions was evaluated by House-Brackmann(H-B)facial nerve function evaluation grading system.Before and after treatment,the surface electromyography(sEMG)was used to detect the root-mean-square(RMS)of frontal muscles,cheek muscles,and orbicularis oris muscles to compare the RMS ratio of these muscles of affected side and healthy side.Results:After 3 courses of treatment,9 cases were cured,22 cases were effective,and 4 cases were ineffective.The total effective rate was 88.6%(31/35).After treatment,the RMS of frontal muscles,cheek muscles,and orbicularis oris muscles of the affected side were 31.56±4.25,34.13±4.28,and 7.46±1.53 respectively,significantly increased in comparing with 11.69±2.45,12.98±3.34,and 2.62±1.41 respectively before treatment(all P<0.05).After treatment,the RMS ratios of frontal muscles,cheek muscles,and orbicularis oris muscles of the affected side and healthy side were 0.73±0.09,0.71±0.11,and 0.68±0.08 respectively,greatly increased in comparing with 0.28±0.10,0.27±0.08,and 0.22±0.09 respectively before treatment(all P<0.05).Conclusion:Acupoint catgut embedding and ginger-separated moxibustion in combination can significantly improve the facial nerve functions,and sEMG used for evaluating the therapeutic effect can objectively reflect the effect of treatment.展开更多
Objective:To investigate the efteets of traditional Chinese medicine.Danzhi decoction,on the expression angiogenesis factors in human endometrial cells during the sequelae of pelvic inflammatoty disease(SPID) and expl...Objective:To investigate the efteets of traditional Chinese medicine.Danzhi decoction,on the expression angiogenesis factors in human endometrial cells during the sequelae of pelvic inflammatoty disease(SPID) and explore the role of Danzhi decction in improving the blood stasis microenvironment of SPID.Methods:A three-dimensional(3D) co—culture system including human vascular endothelial cells(VECs),endometrial stromal cells and glandular epithelial cells was established in vitro and treated with Danzhi decoction,sterilized water and aspirin respectively.A Milliplex multifunctional liquid chip technique was used to measure the expression levels of vascular endothelial growth factor(VEGF)—A/C/D,fibroblast growth factor-1/2.angiopoietin-2.epidermal growth factor(EGF) HB-EGF,bone morphogenetic protein-9.endoglin.endothehn-l.granulocyte colony stimulating factor,hepatocyte growth factor,interleukin-8,follistatin.placenta growth factor and leptin.The location of angiogenesis factors was monitored by immunofluorescence labeling and confocal laser scanning microscope3 D reconstruction.Results:Endometrial stromal cells and glandular epithelial cells were isolated and primary cultured for establishing a 3D co-culture system.The levels of VEGF—A/C/D in Danzhi decoction group and aspirin group were significantly lower than those in mock group(P<0.05).while there was no significant difference between Danzhi decoction group and aspirin group(P>0.05).Furthermore,the alterative location of VEGF—A/C/D was observed in the cytoplasm of endometrial glandular epithelial cells.Conclusions:Danzhi decoction mav inhibit the expression of VEGF in the blood stasis microenvironment of SPID by targeting the cytoplasm of endometrial glandular epithelial cell.展开更多
AIM: To investigate the risk factors causing structural sequelae after anastomotic leakage in patients with mid to low rectal cancer.METHODS: Prospectively collected data of consecutive subjects who had anastomotic le...AIM: To investigate the risk factors causing structural sequelae after anastomotic leakage in patients with mid to low rectal cancer.METHODS: Prospectively collected data of consecutive subjects who had anastomotic leakage after surgical resection for rectal cancer from March 2006 to May 2013 at Korea University Anam Hospital were retrospectively analyzed. Two subgroup analyses were performed. The patients were initially divided into the sequelae(stricture, fistula, or sinus) and no sequelae groups and then divided into the permanent stoma(PS)and no PS groups. Univariate and multivariate analyses were performed to identify the risk factors of structural sequelae after anastomotic leakage.RESULTS: Structural sequelae after anastomotic leakage were identified in 29 patients(39.7%).Multivariate analysis revealed that diversion ileostomy at the first operation increases the risk of structural sequelae [odds ratio(OR) = 6.741; P = 0.017].Fourteen patients(17.7%) had permanent stoma during the follow-up period(median, 37 mo). Multivariate analysis showed that the tumor level from the dentate line was associated with the risk of permanent stoma(OR = 0.751; P = 0.045).CONCLUSION: Diversion ileostomy at the first operation increased the risk of structural sequelae of the anastomosis, while lower tumor location was associated with the risk of permanent stoma in the management of anastomotic leakage.展开更多
Currently, there is no known optimal therapy for carbon monoxide （CO） poisoning and CO-associated delayed neu- rological sequelae. Hyperbaric oxygen therapy （HBOT） is a well-known treatment method, but its use for...Currently, there is no known optimal therapy for carbon monoxide （CO） poisoning and CO-associated delayed neu- rological sequelae. Hyperbaric oxygen therapy （HBOT） is a well-known treatment method, but its use for CO poison- ing patients is controversial to use due to lack of evidences regarding its efficacy. Thus, it is unlikely that HBOT alone will be accepted as the standard treatment method. In this article, current and potential treatment methods of CO poi- soning are presented as well as the tentative multi-factorial pathophysiology. A series of treatments are suggested for use as a bundle therapy, with targeted temperature management as the base treatment method. Such a therapy holds a great potential, especially for the cases where HBOT is not readily available. We suggest further investigations for elucidating the effects of these suggested treatments and their roles in terms of the complex pathophysiology of CO poisoning. Future ac- ceptance of this therapy based on the improved scientific and clinical knowledge may result in injury prevention and mini- mization of the signs and the symptoms in CO poisoning.展开更多
Coronavirus disease 2019(COVID-19)is caused by the novel viral pathogen,severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).COVID-19 primarily involves the lungs.Nucleic acid testing based on reverse-transcrip...Coronavirus disease 2019(COVID-19)is caused by the novel viral pathogen,severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).COVID-19 primarily involves the lungs.Nucleic acid testing based on reverse-transcription polymerase chain reaction of respiratory samples is the current gold standard for the diagnosis of SARS-CoV-2 infection.Imaging modalities have an established role in triaging,diagnosis,evaluation of disease severity,monitoring disease progression,extra-pulmonary involvement,and complications.As our understanding of the disease improves,there has been substantial evidence to highlight its potential for multi-systemic involvement and development of longterm sequelae.Molecular imaging techniques are highly sensitive,allowing noninvasive visualization of physiological or pathological processes at a cellular or molecular level with potential for detection of functional changes earlier than conventional radiological imaging.The purpose of this review article is to highlight the evolving role of molecular imaging in evaluation of COVID-19 sequelae.Though not ideal for diagnosis,the various modalities of molecular imaging play an important role in assessing pulmonary and extra-pulmonary sequelae of COVID-19.Perfusion imaging using single photon emission computed tomography fused with computed tomography(CT)can be utilized as a first-line imaging modality for COVID-19 related pulmonary embolism.^(18)F-fluorodeoxyglucose positron emission tomography(PET)/CT is a sensitive tool to detect multi-systemic inflammation,including myocardial and vascular inflammation.PET in conjunction with magnetic resonance imaging helps in better characterization of neurological sequelae of COVID-19.Despite the fact that the majority of published literature is retrospective in nature with limited sample sizes,it is clear that molecular imaging provides additional valuable information(complimentary to anatomical imaging)with semi-quantitative or quantitative parameters to define inflammatory burden and can be used to guide therapeutic strategies and assess response.However,widespread clinical applicability remains a challenge owing to longer image acquisition times and the need for adoption of infection control protocols.展开更多
In December 2019,a novel coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)was initially reported in Wuhan,China.Previous epidemics including SARS and middle east r...In December 2019,a novel coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)was initially reported in Wuhan,China.Previous epidemics including SARS and middle east respiratory syndrome raises concern that COVID-19 infection may pose a significant threat to the mental health of affected individuals.Studies and reviews have shown the acute psychiatric manifestations in COVID-19 patients,although long term psychiatric sequelae are predicted,there are only few review studies about the long term psychiatry outcome in COVID-19 survivors.Clinically significant posttraumatic stress disorder,anxiety,and/or depression among COVID-19 survivors during 14-90 d were observed following the diagnosis.Risk of anxiety or depression were higher in patients with more severe illness at 6 mo follow-up,early convalescence,and at 1 mo follow-up.Diagnosis of COVID-19 Led to more first diagnoses and relapses of psychiatric illness during the first 14-90 d after COVID-19 diagnosis.The possible underlying mechanisms of psychiatric sequelae in COVID-19 infection are neurotropism,immune response to SARS-CoV-2,hypothalamo-pituitary-adrenal axis hyperactivity,disrupted neuronal circuits in several brain regions,increased stress levels,neuroinflammation,and neuronal death.This study will review the psychiatric sequelae in previous coronavirus pandemics,current studies,risk factors,and thorough explanation on pathophysiology of the psychiatric sequalae in COVID-19 survivors.展开更多
In the present paper, 54 cases of apoplectic sequelae were treated with acupuncture plus Chinese medicinal herbs. Acupoints used were scalp point Motor Area (MS 6), points of body acupuncture: Jianyu(LI 15) and Shousa...In the present paper, 54 cases of apoplectic sequelae were treated with acupuncture plus Chinese medicinal herbs. Acupoints used were scalp point Motor Area (MS 6), points of body acupuncture: Jianyu(LI 15) and Shousanli(LI 10) for paralysis of the upper limb; Zusanli (ST 36)and Xuanzhong (GB 39) for paralysis of the lower limb, combined with other points based on syndromes. Chinese medicinal herbs for reinforcing qi, promoting blood circulation, relieving muscular spasm and dredging meridians were used. Patients of the control group were treated with Troxerutinum, enteric Aspirin, etc.. Findings showed that out of the 54 cases of the treatment group, 28 were cured basically, 16 had marked improvement, 8 had improvement and 2 were ineffective, with the total effective rate of 96. 3%; of the 28 cases in the control group, 3 were cured basically, 7 had striking improvement, 13 had improvement and 5 were ineffective, with the total effective rate of 82.2%.Both the total effective rate and the basic-cure rate of the treatment group were significantly higher than those of the control group (P<0. 01). Results of the present paper display that manipulating the needle to cause "qi reaching the affected area" and applying Chinese medicinal herbs can act on the locus by way of meridians which is the key point for achieving better therapeutic effect.展开更多
One hundred and sixty cases of sequelae of cerebrovascular accident (CVA) wererandomly divided into three groups: The temporal point group (TG), 58 cases; the scalp acupuncturegroup(SG), 52 cases; the body acupuncture...One hundred and sixty cases of sequelae of cerebrovascular accident (CVA) wererandomly divided into three groups: The temporal point group (TG), 58 cases; the scalp acupuncturegroup(SG), 52 cases; the body acupuncture group(BG), 50 cases. It was shown that after 30 treat-ments the curative effects were significantly different (P【0. 01) among the three groups. The effectin TG was better than those in SG and BG. There was no difference in curative effects between SGand BG. It is indicated that all the three needling techniques can improve encephalic blood flow in pa-tients. It seems that the effects of the three needling techniques are as follows: TG】SG】BG.展开更多
The present paper reports a clinical study on treatment of apoplectic hemiplegia with balance-acupuncture therapy. Main (balance acupuncture) point used was Piantan (BP-HN 2), combined with Jiantong (BP-LE 6), Qitong ...The present paper reports a clinical study on treatment of apoplectic hemiplegia with balance-acupuncture therapy. Main (balance acupuncture) point used was Piantan (BP-HN 2), combined with Jiantong (BP-LE 6), Qitong (BP-UE 2), etc.. Of the 190 cases, 148 (77. 89% ) were cured, 24 (12.63 % ) had marked improvement, 12 (6. 32 % ) had improvement and 6 (3. 16 % ) had no effect, with a cure rate of 77. 89 % and an effective rate of 96. 84 %.展开更多
Chicken pox is a disease of childhood caused by varicella zoster virus belonging to the α-herpesvirus-3 family. But the clinical presentation in adults is uncommon and is usually associated with complications. The co...Chicken pox is a disease of childhood caused by varicella zoster virus belonging to the α-herpesvirus-3 family. But the clinical presentation in adults is uncommon and is usually associated with complications. The complications are more commonly seen in immunocompromised individuals and in people who get infected at the later age group. Since the varicella zoster virus rarely causes cerebellar disease in adults, hence here we report a non-immunized, immune-competent adult patient presented to the emergency department with unsteadiness in gait, profuse sweating, exanthematous vesicular rash. We made a diagnosis of acute cerebellar ataxia due to varicella zoster virus and treated accordingly.展开更多
AIM:To evaluate chronic ocular sequelae in patients with symblepharon caused by ocular burns and propose an objective grading system.METHODS:This was a retrospective,single-center clinical study.Patients with symbleph...AIM:To evaluate chronic ocular sequelae in patients with symblepharon caused by ocular burns and propose an objective grading system.METHODS:This was a retrospective,single-center clinical study.Patients with symblepharon caused by ocular burns at least six months later were assessed.Chronic ocular sequelae were classified into 3 categories(eyelid,conjunctiva,and cornea)and 9 chronic ocular sequelae[friction factors,exposure factors,conjunctival hyperemia,length of symblepharon,scope of adhesion,lacrimal area adhesion,loss of the palisades of Vogt(POV),corneal neovascularization,and corneal opacification].Each ocular sequela was graded from 0 to 3,depending on the increasing severity.The 9 ocular sequelae were evaluated to obtain the total severity score for each eye.The total severity score was defined as Grade I(1-9),Grade II(10-18),and Grade III(19-27).Moreover,the correlation between the severity of chronic ocular sequelae and visual acuity,surgical strategy,and the prognosis was analyzed,respectively.RESULTS:Cases of 79 eyes with symblepharon caused by ocular burns were included in this study.Of these,20(25.32%)were defined as Grade I,43(54.43%)as Grade II,and 16(20.25%)as Grade III.Eyes with a high total severity score had reduced visual acuity,required complicated surger y strategies,and poor prognosis(P<0.001).Multivariate regression analysis showed that the scope of adhesion,corneal opacification,and corneal neovascularization significantly affected visual acuity,surgical strategy,and prognosis(all P<0.001).CONCLUSION:The evaluation of chronic ocular sequelae enabled the development of an objective grading system for patients with symblepharon caused by ocular burns.This grading system can be applied to guide the treatment and predict the prognosis.展开更多
文摘In this article,we comment on the article by Oommen et al.Oommen et al provided a comprehensive overview of the management of hip centre restoration in total hip arthroplasty(THA)for childhood hip disorder sequelae.Given the developmental disparity in this population,specific preoperative planning is an essential prerequisite for the success of THA procedures.In the review by Oommen et al,assessments of acetabular and femoral anatomic variations were fully described.However,spinal malalignment and stiffness are common in physical and radiological examinations and should be taken into careful consideration when planning surgical procedures.Poor outcomes of THA for patients with comorbid hip and spinopelvic pathologies have been widely reported,especially for hips with childhood disorder sequelae.Therefore,in this editorial,we would like to emphasize the need for a thorough hip-spine evaluation of patients with childhood hip disorder sequelae before THA.
文摘Adults requiring total hip arthroplasty(THA)for childhood disorder sequelae present with shortening,limp,pain,and altered gait.THA,which can be particularly challenging due to altered anatomy,requires careful planning,assessment,and computed tomography evaluation.Preoperative templating is essential to establish the appropriate acetabular and femoral size.Information regarding neck length and offset is needed to ensure the proper options are available at THA.Hip centre restoration must be planned preoperatively and achieved intraoperatively with appropriate exposure,identification,and stable fixation with optimum-size components.Identifying the actual acetabular floor is essential as changes include altered anatomy,distortion of the margins and version changes.Proximal femur changes include anatomical variation,decreased canal diameter,cortical thickness,changes in anteversion,and metaphyseal and diaphyseal mismatch.Preoperative assessment should consist of limb assessment for variations due to prior surgical procedures.Evaluation of the shortening pattern with the relationship of the lesser trochanter to the teardrop would help identify and plan for subtrochanteric shortening osteotomy,especially in high-riding hips.The surgical approach must ensure adequate exposure and soft tissue release to achieve restoration of the anatomical hip centre.The femoral components may require modularity to enable restoration of anteversion and optimum fixation.
文摘Hip arthroplasty in patients with a history of paediatric hip disorders presents a significant challenge for orthopaedic surgeons.These patients are typically younger and have greater functional demands.Therefore,achieving optimal biomechanical conditions is crucial,involving placement of the acetabulum at the ideal centre of rotation and securing a stable femoral component with good offset to preserve abductor muscle function and restore leg length.The altered anatomy in these cases makes total hip arthroplasty more complex,necessitating thorough preoperative imaging and an individualised surgical approach.Various techniques may be employed to optimise biomechanical outcomes.We propose a modified lateral hip approach,offering exceptional visualisation of the acetabulum and femur while preserving the continuity of the abductor muscles without requiring trochanteric osteotomy.To achieve the most biomechanically advantageous acetabular position,cotyloplasty is our preferred method.
文摘Sequelae of Pelvic Inflammatory Diseases (SPID) is a common and frequent disease in gynecology, which adversely affects women’s reproductive health and quality of life due to its prolonged course. In recent years, traditional Chinese medicine (TCM) in China has gradually shown its clinical advantages in the treatment of SPID. Therefore, the present review summarizes the etiology and pathogenesis of SPID, the evidence typology, and the clinical application effects of moxibustion, herbal retention enema, acupoint compresses, external application of traditional Chinese medicine, auricular pressure beans, tuina massage, traditional Chinese medicine gongfu, and other commonly used Chinese medicine nursing techniques, with the aim of providing references and experiences for the subsequent related studies.
文摘The research progress of brain-derived neurotrophic factor (BDNF) in the treatment of sequelae of stroke is an important topic. Stroke is among the diseases with the highest mortality and disability rates among the elderly in China. BDNF plays an important role in the development and functional maintenance of the nervous system. In recent years, the application value of BDNF in rehabilitation therapy has gradually received attention. This study has adopted a systematic literature review method, searched Chinese and English databases, screened relevant studies, and conducted data extraction and quality evaluation. This review systematically introduced the research progress of BDNF in the correlation with post-stroke sequelae, with special attention to its application in post-stroke depression, motor dysfunction, and cognitive dysfunction. The results showed that a decrease in BDNF levels is closely related to the exacerbation of depressive symptoms, limited recovery of motor dysfunction, and the occurrence of cognitive dysfunction. BDNF, as a key neurobiological factor, has shown significant potential in the rehabilitation treatment of stroke. By exploring the potential of BDNF as a therapeutic target to prevent and treat sequelae of ischemic stroke, the current research bottlenecks, and the development trends of future treatment strategies.
文摘This case report presents a 63-year-old male patient with a history of TB 20 years prior, who developed chronic cor pulmonale, right heart failure, and eventually died. The report emphasizes the serious long-term effects of post-TB sequelae, highlighting diagnostic challenges, clinical progression, and management strategies. The case report addresses a significant and often overlooked aspect of TB management: the long-term complications following TB treatment, known as post-TB sequelae.
文摘Introduction: The treatment of panfacial fractures is complex and constitutes a challenge for the maxillofacial surgeon, who, despite therapeutic progress, frequently suffers functional and aesthetic sequelae. This study aimed to describe the treatment and evaluate the functional and aesthetic sequelae of panfacial fractures in the stomatology and maxillofacial surgery department of the Treichville University Hospital. Materials and Methods: We conducted a retrospective study over a 6 years in the stomatology and maxillofacial surgery department of Treichville University Hospital. Forty-two patients with panfacial fractures were included in the study. Results: Forty-two patients were registered. The average time to osteosynthesis was 12.4 days. Nasotracheal intubation was used most often (88%), and in the majority of cases, mixed osteosynthesis combining a screwed plate and steel wire was performed (64.29%). The “Bottom-up and Outside-in” surgical sequence was the most commonly used (64.29%). All patients had at least one functional and/or cosmetic sequela after treatment. Functional sequelae were dominated by occlusal problems and aesthetic sequelae by nasal deformities. Discussion: Panfacial fractures are characterised by their complexity, presenting maxillo-facial surgeons with a therapeutic and evolutionary challenge. The quality of the initial, often multidisciplinary, management of panfacial fractures is an essential factor in both functional and aesthetic prognosis. Conclusion: The treatment of panfacial fractures, even if well managed, is sometimes a source of sequelae, requiring often complex secondary management.
文摘Objective:To explore the therapeutic effect of acupoint catgut embedding combined with gingerseparated moxibustion for sequelae of peripheral facial paralysis and whether surface electromyography(sEMG)can be an outcome to evaluate the effect of this disease.Methods:Thirty-five patients with sequelae of peripheral facial paralysis were treated with catgut embedding at the acupoints selected according to their individual symptoms and traditional Chinese medicine(TCM)differentiated syndromes.At the same time,the ginger-separated moxibustion was applied at Yifeng(翳风TE17)and Qianzheng(牵正EX-HN16)of the affected side.The catgut embedding was applied once every 15 days,one time of treatment is of one course,and a total of three courses were given.The moxibustion would be taken after 5 days of catgut embedding each time,once every other day,5 times as one course,a total of 3 courses are given.After treatment,the recovery of facial nerve functions was evaluated by House-Brackmann(H-B)facial nerve function evaluation grading system.Before and after treatment,the surface electromyography(sEMG)was used to detect the root-mean-square(RMS)of frontal muscles,cheek muscles,and orbicularis oris muscles to compare the RMS ratio of these muscles of affected side and healthy side.Results:After 3 courses of treatment,9 cases were cured,22 cases were effective,and 4 cases were ineffective.The total effective rate was 88.6%(31/35).After treatment,the RMS of frontal muscles,cheek muscles,and orbicularis oris muscles of the affected side were 31.56±4.25,34.13±4.28,and 7.46±1.53 respectively,significantly increased in comparing with 11.69±2.45,12.98±3.34,and 2.62±1.41 respectively before treatment(all P<0.05).After treatment,the RMS ratios of frontal muscles,cheek muscles,and orbicularis oris muscles of the affected side and healthy side were 0.73±0.09,0.71±0.11,and 0.68±0.08 respectively,greatly increased in comparing with 0.28±0.10,0.27±0.08,and 0.22±0.09 respectively before treatment(all P<0.05).Conclusion:Acupoint catgut embedding and ginger-separated moxibustion in combination can significantly improve the facial nerve functions,and sEMG used for evaluating the therapeutic effect can objectively reflect the effect of treatment.
基金supported by a grant from the National Natural Science Founlation of China(81373677)
文摘Objective:To investigate the efteets of traditional Chinese medicine.Danzhi decoction,on the expression angiogenesis factors in human endometrial cells during the sequelae of pelvic inflammatoty disease(SPID) and explore the role of Danzhi decction in improving the blood stasis microenvironment of SPID.Methods:A three-dimensional(3D) co—culture system including human vascular endothelial cells(VECs),endometrial stromal cells and glandular epithelial cells was established in vitro and treated with Danzhi decoction,sterilized water and aspirin respectively.A Milliplex multifunctional liquid chip technique was used to measure the expression levels of vascular endothelial growth factor(VEGF)—A/C/D,fibroblast growth factor-1/2.angiopoietin-2.epidermal growth factor(EGF) HB-EGF,bone morphogenetic protein-9.endoglin.endothehn-l.granulocyte colony stimulating factor,hepatocyte growth factor,interleukin-8,follistatin.placenta growth factor and leptin.The location of angiogenesis factors was monitored by immunofluorescence labeling and confocal laser scanning microscope3 D reconstruction.Results:Endometrial stromal cells and glandular epithelial cells were isolated and primary cultured for establishing a 3D co-culture system.The levels of VEGF—A/C/D in Danzhi decoction group and aspirin group were significantly lower than those in mock group(P<0.05).while there was no significant difference between Danzhi decoction group and aspirin group(P>0.05).Furthermore,the alterative location of VEGF—A/C/D was observed in the cytoplasm of endometrial glandular epithelial cells.Conclusions:Danzhi decoction mav inhibit the expression of VEGF in the blood stasis microenvironment of SPID by targeting the cytoplasm of endometrial glandular epithelial cell.
文摘AIM: To investigate the risk factors causing structural sequelae after anastomotic leakage in patients with mid to low rectal cancer.METHODS: Prospectively collected data of consecutive subjects who had anastomotic leakage after surgical resection for rectal cancer from March 2006 to May 2013 at Korea University Anam Hospital were retrospectively analyzed. Two subgroup analyses were performed. The patients were initially divided into the sequelae(stricture, fistula, or sinus) and no sequelae groups and then divided into the permanent stoma(PS)and no PS groups. Univariate and multivariate analyses were performed to identify the risk factors of structural sequelae after anastomotic leakage.RESULTS: Structural sequelae after anastomotic leakage were identified in 29 patients(39.7%).Multivariate analysis revealed that diversion ileostomy at the first operation increases the risk of structural sequelae [odds ratio(OR) = 6.741; P = 0.017].Fourteen patients(17.7%) had permanent stoma during the follow-up period(median, 37 mo). Multivariate analysis showed that the tumor level from the dentate line was associated with the risk of permanent stoma(OR = 0.751; P = 0.045).CONCLUSION: Diversion ileostomy at the first operation increased the risk of structural sequelae of the anastomosis, while lower tumor location was associated with the risk of permanent stoma in the management of anastomotic leakage.
文摘Currently, there is no known optimal therapy for carbon monoxide （CO） poisoning and CO-associated delayed neu- rological sequelae. Hyperbaric oxygen therapy （HBOT） is a well-known treatment method, but its use for CO poison- ing patients is controversial to use due to lack of evidences regarding its efficacy. Thus, it is unlikely that HBOT alone will be accepted as the standard treatment method. In this article, current and potential treatment methods of CO poi- soning are presented as well as the tentative multi-factorial pathophysiology. A series of treatments are suggested for use as a bundle therapy, with targeted temperature management as the base treatment method. Such a therapy holds a great potential, especially for the cases where HBOT is not readily available. We suggest further investigations for elucidating the effects of these suggested treatments and their roles in terms of the complex pathophysiology of CO poisoning. Future ac- ceptance of this therapy based on the improved scientific and clinical knowledge may result in injury prevention and mini- mization of the signs and the symptoms in CO poisoning.
文摘Coronavirus disease 2019(COVID-19)is caused by the novel viral pathogen,severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).COVID-19 primarily involves the lungs.Nucleic acid testing based on reverse-transcription polymerase chain reaction of respiratory samples is the current gold standard for the diagnosis of SARS-CoV-2 infection.Imaging modalities have an established role in triaging,diagnosis,evaluation of disease severity,monitoring disease progression,extra-pulmonary involvement,and complications.As our understanding of the disease improves,there has been substantial evidence to highlight its potential for multi-systemic involvement and development of longterm sequelae.Molecular imaging techniques are highly sensitive,allowing noninvasive visualization of physiological or pathological processes at a cellular or molecular level with potential for detection of functional changes earlier than conventional radiological imaging.The purpose of this review article is to highlight the evolving role of molecular imaging in evaluation of COVID-19 sequelae.Though not ideal for diagnosis,the various modalities of molecular imaging play an important role in assessing pulmonary and extra-pulmonary sequelae of COVID-19.Perfusion imaging using single photon emission computed tomography fused with computed tomography(CT)can be utilized as a first-line imaging modality for COVID-19 related pulmonary embolism.^(18)F-fluorodeoxyglucose positron emission tomography(PET)/CT is a sensitive tool to detect multi-systemic inflammation,including myocardial and vascular inflammation.PET in conjunction with magnetic resonance imaging helps in better characterization of neurological sequelae of COVID-19.Despite the fact that the majority of published literature is retrospective in nature with limited sample sizes,it is clear that molecular imaging provides additional valuable information(complimentary to anatomical imaging)with semi-quantitative or quantitative parameters to define inflammatory burden and can be used to guide therapeutic strategies and assess response.However,widespread clinical applicability remains a challenge owing to longer image acquisition times and the need for adoption of infection control protocols.
文摘In December 2019,a novel coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)was initially reported in Wuhan,China.Previous epidemics including SARS and middle east respiratory syndrome raises concern that COVID-19 infection may pose a significant threat to the mental health of affected individuals.Studies and reviews have shown the acute psychiatric manifestations in COVID-19 patients,although long term psychiatric sequelae are predicted,there are only few review studies about the long term psychiatry outcome in COVID-19 survivors.Clinically significant posttraumatic stress disorder,anxiety,and/or depression among COVID-19 survivors during 14-90 d were observed following the diagnosis.Risk of anxiety or depression were higher in patients with more severe illness at 6 mo follow-up,early convalescence,and at 1 mo follow-up.Diagnosis of COVID-19 Led to more first diagnoses and relapses of psychiatric illness during the first 14-90 d after COVID-19 diagnosis.The possible underlying mechanisms of psychiatric sequelae in COVID-19 infection are neurotropism,immune response to SARS-CoV-2,hypothalamo-pituitary-adrenal axis hyperactivity,disrupted neuronal circuits in several brain regions,increased stress levels,neuroinflammation,and neuronal death.This study will review the psychiatric sequelae in previous coronavirus pandemics,current studies,risk factors,and thorough explanation on pathophysiology of the psychiatric sequalae in COVID-19 survivors.
文摘In the present paper, 54 cases of apoplectic sequelae were treated with acupuncture plus Chinese medicinal herbs. Acupoints used were scalp point Motor Area (MS 6), points of body acupuncture: Jianyu(LI 15) and Shousanli(LI 10) for paralysis of the upper limb; Zusanli (ST 36)and Xuanzhong (GB 39) for paralysis of the lower limb, combined with other points based on syndromes. Chinese medicinal herbs for reinforcing qi, promoting blood circulation, relieving muscular spasm and dredging meridians were used. Patients of the control group were treated with Troxerutinum, enteric Aspirin, etc.. Findings showed that out of the 54 cases of the treatment group, 28 were cured basically, 16 had marked improvement, 8 had improvement and 2 were ineffective, with the total effective rate of 96. 3%; of the 28 cases in the control group, 3 were cured basically, 7 had striking improvement, 13 had improvement and 5 were ineffective, with the total effective rate of 82.2%.Both the total effective rate and the basic-cure rate of the treatment group were significantly higher than those of the control group (P<0. 01). Results of the present paper display that manipulating the needle to cause "qi reaching the affected area" and applying Chinese medicinal herbs can act on the locus by way of meridians which is the key point for achieving better therapeutic effect.
文摘One hundred and sixty cases of sequelae of cerebrovascular accident (CVA) wererandomly divided into three groups: The temporal point group (TG), 58 cases; the scalp acupuncturegroup(SG), 52 cases; the body acupuncture group(BG), 50 cases. It was shown that after 30 treat-ments the curative effects were significantly different (P【0. 01) among the three groups. The effectin TG was better than those in SG and BG. There was no difference in curative effects between SGand BG. It is indicated that all the three needling techniques can improve encephalic blood flow in pa-tients. It seems that the effects of the three needling techniques are as follows: TG】SG】BG.
文摘The present paper reports a clinical study on treatment of apoplectic hemiplegia with balance-acupuncture therapy. Main (balance acupuncture) point used was Piantan (BP-HN 2), combined with Jiantong (BP-LE 6), Qitong (BP-UE 2), etc.. Of the 190 cases, 148 (77. 89% ) were cured, 24 (12.63 % ) had marked improvement, 12 (6. 32 % ) had improvement and 6 (3. 16 % ) had no effect, with a cure rate of 77. 89 % and an effective rate of 96. 84 %.
文摘Chicken pox is a disease of childhood caused by varicella zoster virus belonging to the α-herpesvirus-3 family. But the clinical presentation in adults is uncommon and is usually associated with complications. The complications are more commonly seen in immunocompromised individuals and in people who get infected at the later age group. Since the varicella zoster virus rarely causes cerebellar disease in adults, hence here we report a non-immunized, immune-competent adult patient presented to the emergency department with unsteadiness in gait, profuse sweating, exanthematous vesicular rash. We made a diagnosis of acute cerebellar ataxia due to varicella zoster virus and treated accordingly.
基金Supported by the National Natural Science Foundation of China(No.81770888)the Shanghai Municipal Education Commission Gaofeng Clinical Medicine Grant Support(No.20161421)+2 种基金the Shanghai Municipal Science and Technology Commission the Commercialization and Industrialization of Research Findings Project(No.17411963800)Shanghai Pujiang Program(No.18PJD025)Shanghai Jiao Tong University School of Medicine Two-hundred Talent(No.20191914)。
文摘AIM:To evaluate chronic ocular sequelae in patients with symblepharon caused by ocular burns and propose an objective grading system.METHODS:This was a retrospective,single-center clinical study.Patients with symblepharon caused by ocular burns at least six months later were assessed.Chronic ocular sequelae were classified into 3 categories(eyelid,conjunctiva,and cornea)and 9 chronic ocular sequelae[friction factors,exposure factors,conjunctival hyperemia,length of symblepharon,scope of adhesion,lacrimal area adhesion,loss of the palisades of Vogt(POV),corneal neovascularization,and corneal opacification].Each ocular sequela was graded from 0 to 3,depending on the increasing severity.The 9 ocular sequelae were evaluated to obtain the total severity score for each eye.The total severity score was defined as Grade I(1-9),Grade II(10-18),and Grade III(19-27).Moreover,the correlation between the severity of chronic ocular sequelae and visual acuity,surgical strategy,and the prognosis was analyzed,respectively.RESULTS:Cases of 79 eyes with symblepharon caused by ocular burns were included in this study.Of these,20(25.32%)were defined as Grade I,43(54.43%)as Grade II,and 16(20.25%)as Grade III.Eyes with a high total severity score had reduced visual acuity,required complicated surger y strategies,and poor prognosis(P<0.001).Multivariate regression analysis showed that the scope of adhesion,corneal opacification,and corneal neovascularization significantly affected visual acuity,surgical strategy,and prognosis(all P<0.001).CONCLUSION:The evaluation of chronic ocular sequelae enabled the development of an objective grading system for patients with symblepharon caused by ocular burns.This grading system can be applied to guide the treatment and predict the prognosis.
