Pub Date : 2024-10-08DOI: 10.3760/cma.j.cn112137-20240525-01192
H P Cui, H W Xi, Z F Shi, J Li, J Y Dai, Y Liu
To explore the characteristics of pediatric primary retroperitoneal teratoma and the influencing factors of perioperative complications. The clinical data, imaging data, pathology results, perioperative complications, etc of patients with primary retroperitoneal teratoma admitted and treated at Shanxi Children's Hospital from March 2013 to September 2023 were retrospectively analyzed. The patients were divided into no complication group and complication group according to whether there were perioperative complications. The differences between the two groups were compared, and the influencing factors of complications were analyzed by multivariate logistic regression model. A total of 33 patients were included in this study, including 7 males and 26 females, with an age of [M (Q1, Q3), 9.0 (4.0, 24.0)] months. Nineteen cases had tumors located in the left upper abdomen and 14 cases in the right upper abdomen, among which 17 cases grew across the midline, with the maximum tumor diameter of (12.9±4.5) cm. All patients had anatomical displacement of retroperitoneal vessels and organs: the number of anatomical displaced arteries was 3 (3, 4), the number of anatomical displaced veins was 4 (3, 5), the number of anatomical displaced organs was 5 (4, 6). Pathologic examination revealed 28 mature teratomas (Grade 0 and Grade 1) and 5 immature teratomas (Grade 2 and Grade 3). There were 18 cases in no complication group and 15 cases in the complication group. The incidence of perioperative complications was 45.5% (15/33). The number of tumors crossing the midline (6/18 vs 11/15, P=0.037), the number of tumors adhering closely to the surrounding tissues (7/18 vs 12/15, P=0.033), the number of anatomical displaced veins [4 (3, 4) vs 5 (4, 5), P=0.001], and the number of anatomical displaced organs [4 (3, 5) vs 6 (5, 6), P=0.001] were significantly different between the two groups. Multivariate logistic regression model analysis showed that the number of anatomical displaced organs (OR=8.781, 95%CI: 2.155-35.784, P=0.002) was the influencing factor for perioperative complications of pediatric primary retroperitoneal teratoma.
目的 探讨小儿原发性腹膜后畸胎瘤的特点及围手术期并发症的影响因素。回顾性分析2013年3月-2023年9月山西省儿童医院收治的原发性腹膜后畸胎瘤患者的临床资料、影像学资料、病理结果、围手术期并发症等。根据是否出现围手术期并发症将患者分为无并发症组和并发症组。比较两组之间的差异，并通过多变量逻辑回归模型分析并发症的影响因素。本研究共纳入33例患者，其中男性7例，女性26例，年龄[M（Q1，Q3），9.0（4.0，24.0）]个月。19例肿瘤位于左上腹，14例位于右上腹，其中17例肿瘤跨越中线生长，最大肿瘤直径为（12.9±4.5）厘米。所有患者腹膜后血管和脏器均有解剖学移位：解剖学移位动脉数为3（3，4），解剖学移位静脉数为4（3，5），解剖学移位脏器数为5（4，6）。病理检查发现成熟畸胎瘤 28 例（0 级和 1 级），未成熟畸胎瘤 5 例（2 级和 3 级）。无并发症组 18 例，并发症组 15 例。围手术期并发症的发生率为 45.5%（15/33）。肿瘤越过中线的数量（6/18 vs 11/15，P=0.037）、肿瘤与周围组织紧密粘连的数量（7/18 vs 12/15，P=0.033）、解剖移位静脉的数量[4（3，4） vs 5（4，5），P=0.001]和解剖移位器官的数量[4（3，5） vs 6（5，6），P=0.001]在两组间有显著差异。多变量逻辑回归模型分析显示，解剖移位器官数量（OR=8.781，95%CI：2.155-35.784，P=0.002）是小儿原发性腹膜后畸胎瘤围手术期并发症的影响因素。
{"title":"[The characteristics of pediatric primary retroperitoneal teratoma and the influencing factors of perioperative complications].","authors":"H P Cui, H W Xi, Z F Shi, J Li, J Y Dai, Y Liu","doi":"10.3760/cma.j.cn112137-20240525-01192","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240525-01192","url":null,"abstract":"<p><p>To explore the characteristics of pediatric primary retroperitoneal teratoma and the influencing factors of perioperative complications. The clinical data, imaging data, pathology results, perioperative complications, etc of patients with primary retroperitoneal teratoma admitted and treated at Shanxi Children<sup>'</sup>s Hospital from March 2013 to September 2023 were retrospectively analyzed. The patients were divided into no complication group and complication group according to whether there were perioperative complications. The differences between the two groups were compared, and the influencing factors of complications were analyzed by multivariate logistic regression model. A total of 33 patients were included in this study, including 7 males and 26 females, with an age of [<i>M</i> (<i>Q</i><sub>1</sub>, <i>Q</i><sub>3</sub>), 9.0 (4.0, 24.0)] months. Nineteen cases had tumors located in the left upper abdomen and 14 cases in the right upper abdomen, among which 17 cases grew across the midline, with the maximum tumor diameter of (12.9±4.5) cm. All patients had anatomical displacement of retroperitoneal vessels and organs: the number of anatomical displaced arteries was 3 (3, 4), the number of anatomical displaced veins was 4 (3, 5), the number of anatomical displaced organs was 5 (4, 6). Pathologic examination revealed 28 mature teratomas (Grade 0 and Grade 1) and 5 immature teratomas (Grade 2 and Grade 3). There were 18 cases in no complication group and 15 cases in the complication group. The incidence of perioperative complications was 45.5% (15/33). The number of tumors crossing the midline (6/18 vs 11/15, <i>P</i>=0.037), the number of tumors adhering closely to the surrounding tissues (7/18 vs 12/15, <i>P</i>=0.033), the number of anatomical displaced veins [4 (3, 4) vs 5 (4, 5), <i>P</i>=0.001], and the number of anatomical displaced organs [4 (3, 5) vs 6 (5, 6), <i>P</i>=0.001] were significantly different between the two groups. Multivariate logistic regression model analysis showed that the number of anatomical displaced organs (<i>OR</i>=8.781, 95%<i>CI</i>: 2.155-35.784, <i>P</i>=0.002) was the influencing factor for perioperative complications of pediatric primary retroperitoneal teratoma.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 37","pages":"3535-3538"},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-08DOI: 10.3760/cma.j.cn112137-20240514-01110
Spinal cord glioma is a group of tumors originated from spinal cord glial cells. They typically have an insidious onset, with early symptoms in patients including sensory disturbances, motor disorder, and sphincter dysfunction. When the course of disease develops to a certain extent, it can lead to paralysis, dyspnea, and even result in death. The spinal cord bears the role of nerve conduction, and acts as a lower central hub for somatic and visceral activities and primary neural reflexes. Because the self-repair ability after injury is limited, spinal cord injury caused by tumor and treatment may be permanent, potentially causing huge economic and social burden. To further standardize the diagnosis and treatment of spinal cord glioma, the expert group formulated The Chinese Expert Consensus on the Diagnosis and Treatment of Spinal Cord Glioma according to the current situation of diagnosis and treatment of spinal cord glioma at home and abroad. This consensus elaborates the epidemiology, natural course, clinical manifestations, diagnosis, treatment, follow-up, and prognosis of spinal gliomas and formulates 17 recommendations. It aims to offer reference for medical personnel and other related individuals.
{"title":"[Chinese expert consensus on diagnosis and treatment of spinal cord glioma].","authors":"","doi":"10.3760/cma.j.cn112137-20240514-01110","DOIUrl":"10.3760/cma.j.cn112137-20240514-01110","url":null,"abstract":"<p><p>Spinal cord glioma is a group of tumors originated from spinal cord glial cells. They typically have an insidious onset, with early symptoms in patients including sensory disturbances, motor disorder, and sphincter dysfunction. When the course of disease develops to a certain extent, it can lead to paralysis, dyspnea, and even result in death. The spinal cord bears the role of nerve conduction, and acts as a lower central hub for somatic and visceral activities and primary neural reflexes. Because the self-repair ability after injury is limited, spinal cord injury caused by tumor and treatment may be permanent, potentially causing huge economic and social burden. To further standardize the diagnosis and treatment of spinal cord glioma, the expert group formulated The Chinese Expert Consensus on the Diagnosis and Treatment of Spinal Cord Glioma according to the current situation of diagnosis and treatment of spinal cord glioma at home and abroad. This consensus elaborates the epidemiology, natural course, clinical manifestations, diagnosis, treatment, follow-up, and prognosis of spinal gliomas and formulates 17 recommendations. It aims to offer reference for medical personnel and other related individuals.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 37","pages":"3478-3489"},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-08DOI: 10.3760/cma.j.cn112137-20240119-00138
M Shi, R R Liu, Y Y Jin, Q L Shi, X X Shen, R Zhang, L J Chen
<p><p><b>Objective:</b> To investigate the prognosis and related factors impacting renal response in newly diagnosed multiple myeloma (NDMM) patients with renal impairment. <b>Methods:</b> A total of 375 NDMM patients diagnosed at the Department of Hematology, the First Affiliated Hospital of Nanjing Medical University from August 2012 to April 2022 were retrospectively recruited. Patients were categorized into non-renal impairment group(<i>n</i>=273) and renal impairment group (<i>n</i>=102) according to renal function at initial diagnosis. All patients received≥2 cycles of bortezomib-based induction chemotherapy after admission. The hematological response included stringent complete response (sCR), complete response (CR), very good partial response (VGPR), partial response (PR) and stable disease (SD). The renal responses were defined as CR, PR, minor response (MR) and non-response (NR). General clinical data of the patients were collected, and patients were followed up by telephone. The follow-up deadline was December 3, 2022, and the median follow-up time [<i>M</i> (<i>Q</i><sub>1</sub>, <i>Q</i><sub>3</sub>)] was 42 (22, 61) months. Kaplan-Meier analysis was used to plot the survival curve. The log-rank test was utilized for inter-group comparisons. Multivariate logistic regression modeling facilitated the exploration of associated factors impacting renal response. <b>Results:</b> In the renal impairment group, there were 68 males and 34 females with a median age [<i>M</i> (<i>Q</i><sub>1</sub>, <i>Q</i><sub>3</sub>)] of 64 (58, 69) years. In the non-renal impairment group, there were 149 males and 124 females with a median age of 62 (54, 68) years. Compared with the renal impairment group, the age, lactate dehydrogenase and 24-hour urinary protein quantity were increased, the proportion of patients with light chain M protein and the proportion of patients at the DS-Ⅲ stage, ISS-Ⅲ stage and R-ISS-Ⅲ stage were higher, the hemoglobin level and the proportion of patients receiving autologous hematopoietic stem cell transplantation were lower in the renal impairment group (all <i>P</i><0.05). In 102 patients with renal impairment, renal responses of CR, PR, MR and NR were obtained in 53 (52.0%), 8 (7.9%), 18 (17.6%), 23 (22.5%) patients, respectively, and the overall response rate was 77.5% (79/102). Kaplan-Meier survival curve revealed that the median progression-free survival (PFS) was 24.0 (95%<i>CI</i>: 18.3-29.7) months in the renal impairment group, which was shorter than 31.0 (95%<i>CI</i>: 24.7-37.3) months in the non-renal impairment group (<i>P</i>=0.003). The median overall survival (OS) was 46.0 (95%<i>CI</i>: 36.5-55.5) months in the renal impairment group, which was shorter than 79.0 (95%<i>CI</i>: 59.9-98.1) months in the non-renal impairment group (<i>P</i>=0.002). Among the renal impairment group, patients with renal response of less than PR exhibited a median PFS of 19.0 (95%<i>CI</i>: 9.7-28.3) months, which was shorter than 2
{"title":"[The prognosis and related factors impacting renal response in newly diagnosed multiple myeloma patients with renal impairment].","authors":"M Shi, R R Liu, Y Y Jin, Q L Shi, X X Shen, R Zhang, L J Chen","doi":"10.3760/cma.j.cn112137-20240119-00138","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240119-00138","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the prognosis and related factors impacting renal response in newly diagnosed multiple myeloma (NDMM) patients with renal impairment. <b>Methods:</b> A total of 375 NDMM patients diagnosed at the Department of Hematology, the First Affiliated Hospital of Nanjing Medical University from August 2012 to April 2022 were retrospectively recruited. Patients were categorized into non-renal impairment group(<i>n</i>=273) and renal impairment group (<i>n</i>=102) according to renal function at initial diagnosis. All patients received≥2 cycles of bortezomib-based induction chemotherapy after admission. The hematological response included stringent complete response (sCR), complete response (CR), very good partial response (VGPR), partial response (PR) and stable disease (SD). The renal responses were defined as CR, PR, minor response (MR) and non-response (NR). General clinical data of the patients were collected, and patients were followed up by telephone. The follow-up deadline was December 3, 2022, and the median follow-up time [<i>M</i> (<i>Q</i><sub>1</sub>, <i>Q</i><sub>3</sub>)] was 42 (22, 61) months. Kaplan-Meier analysis was used to plot the survival curve. The log-rank test was utilized for inter-group comparisons. Multivariate logistic regression modeling facilitated the exploration of associated factors impacting renal response. <b>Results:</b> In the renal impairment group, there were 68 males and 34 females with a median age [<i>M</i> (<i>Q</i><sub>1</sub>, <i>Q</i><sub>3</sub>)] of 64 (58, 69) years. In the non-renal impairment group, there were 149 males and 124 females with a median age of 62 (54, 68) years. Compared with the renal impairment group, the age, lactate dehydrogenase and 24-hour urinary protein quantity were increased, the proportion of patients with light chain M protein and the proportion of patients at the DS-Ⅲ stage, ISS-Ⅲ stage and R-ISS-Ⅲ stage were higher, the hemoglobin level and the proportion of patients receiving autologous hematopoietic stem cell transplantation were lower in the renal impairment group (all <i>P</i><0.05). In 102 patients with renal impairment, renal responses of CR, PR, MR and NR were obtained in 53 (52.0%), 8 (7.9%), 18 (17.6%), 23 (22.5%) patients, respectively, and the overall response rate was 77.5% (79/102). Kaplan-Meier survival curve revealed that the median progression-free survival (PFS) was 24.0 (95%<i>CI</i>: 18.3-29.7) months in the renal impairment group, which was shorter than 31.0 (95%<i>CI</i>: 24.7-37.3) months in the non-renal impairment group (<i>P</i>=0.003). The median overall survival (OS) was 46.0 (95%<i>CI</i>: 36.5-55.5) months in the renal impairment group, which was shorter than 79.0 (95%<i>CI</i>: 59.9-98.1) months in the non-renal impairment group (<i>P</i>=0.002). Among the renal impairment group, patients with renal response of less than PR exhibited a median PFS of 19.0 (95%<i>CI</i>: 9.7-28.3) months, which was shorter than 2","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 37","pages":"3528-3534"},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-08DOI: 10.3760/cma.j.cn112137-20240130-00235
S J Zhao, A Xue, Y Li, J Chen, Z F Huang, W Zhou, L P Yu, G Y Yin, Q Q Li
<p><p><b>Objective:</b> To comparing the accuracy of pedicle screw placement in posterior surgery for adult degenerative scoliosis (ADS) between robotic-assisted and traditional freehand techniques. <b>Methods:</b> This retrospective study included 92 patients with ADS who underwent posterior spinal surgery at the First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital) between March 2019 and December 2023. There were 19 males and 73 females with a mean age of (63.6±9.8) years. The patients were divided into two groups based on the technique used for pedicle screw placement: robot-assisted group (34 cases) and manual group (58 cases). Operative duration, intraoperative blood loss, facet joint violation, postoperative complications, magnitude of curve correction, visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores preoperatively, 1 week postoperatively, and 1 month postoperatively were compared and analyzed between the two groups. The Gertzbein-Robbins classification criteria was used to assess the accuracy of screw placement. <b>Results:</b> Differences in baseline data, operative duration, intraoperative blood loss, magnitude of curve correction, and VAS and ODI scores preoperatively, 1 week postoperatively, and 1 month postoperatively between the two groups exhibited no statistically significant differences (all <i>P</i>>0.05). The accuracy of pedicle screw placement in the robot-assisted group was significantly higher than that in the manual group [90.9% (416/458) vs 80.1% (697/870), <i>P</i><0.001]. In terms of surgical segments, in T<sub>1</sub>-T<sub>12</sub> and L<sub>1</sub>-S<sub>1</sub> segments, the accuracy of pedicle screw placement in the robot group were both significantly higher than those in the control group [91.5% (130/142) vs 77.8% (186/239), <i>P</i>=0.001; 90.3% (271/300) vs 80.8% (502/621), <i>P</i><0.001]. However, no significant differences was observed in the accuracy of S<sub>2</sub>-alar-iliac (S<sub>2</sub>AI) screw placement between the two groups [90.0%(9/10) vs 93.8%(15/16), <i>P</i>=0.727]. Moreover, no significant differences was found in the deviation direction of the cortical screw penetration between both groups (<i>P</i>=0.133). Significant differences were observed in the accuracy of screw placement between the Nash Moe 2 and 3 vertebral bodies in the robot group compared with those in the control group [88.9% (88/99) vs 71.0% (115/162), <i>P</i>=0.001; 89.2% (83/93) vs 60.2% (68/113), <i>P</i><0.001]. Additionally, the incidence and grade of facet joint violation in the manual group were both significantly higher than those in the robot-assisted group (both <i>P</i><0.001). No statistically significant differences was identified in postoperative complications between the two groups (<i>P</i>=0.841). <b>Conclusion:</b> It suggests that robot-assisted pedicle screw placement in posterior surgery for patients with ADS can significantly improve the accuracy of screw
目的：比较机器人辅助和传统徒手技术在成人退行性脊柱侧凸（ADS）后路手术中椎弓根螺钉置入的准确性。方法：这项回顾性研究纳入了2019年3月至2023年12月期间在南京医科大学第一附属医院（江苏省医院）接受脊柱后路手术的92例ADS患者。其中男性19例，女性73例，平均年龄（63.6±9.8）岁。根据椎弓根螺钉置入技术将患者分为两组：机器人辅助组（34例）和人工组（58例）。对两组患者的手术时间、术中失血量、面关节侵犯、术后并发症、曲线矫正幅度、术前、术后一周和术后一个月的视觉模拟量表（VAS）和Oswestry残疾指数（ODI）评分进行了比较和分析。Gertzbein-Robbins分类标准用于评估螺钉置入的准确性。结果：两组患者的基线数据、手术时间、术中失血量、曲线矫正幅度以及术前、术后 1 周和术后 1 个月的 VAS 和 ODI 评分差异无统计学意义（均 P>0.05）。机器人辅助组的椎弓根螺钉置入准确率明显高于人工组[90.9%（416/458） vs 80.1%（697/870），P1-T12 和 L1-S1 节段，机器人组的椎弓根螺钉置入准确率均明显高于对照组[91.5%（130/142） vs 77.8%（186/239），P=0.001；90.3%（271/300） vs 80.8%（502/621），两组间P2-踝-髂（S2AI）螺钉置入[90.0%（9/10） vs 93.8%（15/16），P=0.727]。此外，两组在皮质螺钉穿透的偏离方向上没有发现明显差异（P=0.133）。与对照组相比，机器人组在 Nash Moe 2 和 3 椎体之间放置螺钉的准确性方面存在显著差异[88.9% (88/99) vs 71.0% (115/162)，P=0.001；89.2% (83/93) vs 60.2% (68/113)，PPP=0.841]。结论这表明，机器人辅助椎弓根螺钉置入术在 ADS 患者的后路手术中能显著提高螺钉置入的准确性，降低面关节侵犯的发生率。
{"title":"[Analysis of the accuracy between orthopedic robot-assisted and traditional manual pedicle screw placement techniques in adult degenerative scoliosis posterior surgery].","authors":"S J Zhao, A Xue, Y Li, J Chen, Z F Huang, W Zhou, L P Yu, G Y Yin, Q Q Li","doi":"10.3760/cma.j.cn112137-20240130-00235","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240130-00235","url":null,"abstract":"<p><p><b>Objective:</b> To comparing the accuracy of pedicle screw placement in posterior surgery for adult degenerative scoliosis (ADS) between robotic-assisted and traditional freehand techniques. <b>Methods:</b> This retrospective study included 92 patients with ADS who underwent posterior spinal surgery at the First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital) between March 2019 and December 2023. There were 19 males and 73 females with a mean age of (63.6±9.8) years. The patients were divided into two groups based on the technique used for pedicle screw placement: robot-assisted group (34 cases) and manual group (58 cases). Operative duration, intraoperative blood loss, facet joint violation, postoperative complications, magnitude of curve correction, visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores preoperatively, 1 week postoperatively, and 1 month postoperatively were compared and analyzed between the two groups. The Gertzbein-Robbins classification criteria was used to assess the accuracy of screw placement. <b>Results:</b> Differences in baseline data, operative duration, intraoperative blood loss, magnitude of curve correction, and VAS and ODI scores preoperatively, 1 week postoperatively, and 1 month postoperatively between the two groups exhibited no statistically significant differences (all <i>P</i>>0.05). The accuracy of pedicle screw placement in the robot-assisted group was significantly higher than that in the manual group [90.9% (416/458) vs 80.1% (697/870), <i>P</i><0.001]. In terms of surgical segments, in T<sub>1</sub>-T<sub>12</sub> and L<sub>1</sub>-S<sub>1</sub> segments, the accuracy of pedicle screw placement in the robot group were both significantly higher than those in the control group [91.5% (130/142) vs 77.8% (186/239), <i>P</i>=0.001; 90.3% (271/300) vs 80.8% (502/621), <i>P</i><0.001]. However, no significant differences was observed in the accuracy of S<sub>2</sub>-alar-iliac (S<sub>2</sub>AI) screw placement between the two groups [90.0%(9/10) vs 93.8%(15/16), <i>P</i>=0.727]. Moreover, no significant differences was found in the deviation direction of the cortical screw penetration between both groups (<i>P</i>=0.133). Significant differences were observed in the accuracy of screw placement between the Nash Moe 2 and 3 vertebral bodies in the robot group compared with those in the control group [88.9% (88/99) vs 71.0% (115/162), <i>P</i>=0.001; 89.2% (83/93) vs 60.2% (68/113), <i>P</i><0.001]. Additionally, the incidence and grade of facet joint violation in the manual group were both significantly higher than those in the robot-assisted group (both <i>P</i><0.001). No statistically significant differences was identified in postoperative complications between the two groups (<i>P</i>=0.841). <b>Conclusion:</b> It suggests that robot-assisted pedicle screw placement in posterior surgery for patients with ADS can significantly improve the accuracy of screw","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 37","pages":"3490-3497"},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-08DOI: 10.3760/cma.j.cn112137-20240310-00539
Q H Wang, C Tang, Y M Wang, J Cai, W Wang, F Ran, T Qiao
<p><p><b>Objective:</b> To analyze the correlation between iliac artery calcification score and restenosis of lower extremity arteries in patients with lower extremity atherosclerotic occlusive disease (LEASO) who underwent drug-coated balloon (DCB) combined with stenting, and to assess the predictive value. <b>Methods:</b> A total of 105 patients with LEASO at Nanjing Drum Tower Hospital, Nanjing University Medicine School, from January 2018 to June 2023 were retrospectively included, and the patients were divided into 2 groups according to whether restenosis of the original lower limb arteries had occurred during follow-up after DCB combined stent implantation: the restenosis group (<i>n</i>=64) and the patency group (<i>n</i>=41). The clinical information of the study subjects was collected through the electronic case system, and all patients underwent CTA examination of both lower limb arteries before the operation, and the calcification scores of common iliac arteries and external iliac arteries of patients' bilateral and stenotic sides were calculated according to the results of the CTA examination. The follow-up time [<i>M</i> (<i>Q</i><sub>1</sub>, <i>Q</i><sub>3</sub>)] was 9.15 (5.67, 15.60) months in the patency group and 9.20 (6.85, 19.65) months in the restenosis group. Univariate and multivariate logistic regression models were used to analyze the factors associated with restenosis after DCB combined with stent implantation in LEASO patients. The predictive value of iliac artery calcification score for postoperative restenosis was assessed using the receiver operating characteristic (ROC) curves. <b>Results:</b> There were 44 males and 20 females in the restenosis group, aged (73±9) years; 31 males and 10 females in the patency group, aged (73±10) years. Compared with the patency group, the restenosis group had higher neutrophil counts, platelet counts, lymphocyte counts, neutrophil-to-lymphocyte ratios (NLR), platelet-to-lymphocyte ratios (PLR), C-reactive protein, fibrinogen, stent lengths, stent numbers, common iliac artery calcification scores (bilateral and stenotic side), and external iliac artery calcification scores (bilateral and stenotic side) (all <i>P</i><0.05). Multifactorial logistic regression analysis showed that higher external iliac artery calcification score on the stenotic side (<i>OR</i>=1.480, 95%<i>CI</i>: 1.130-1.939, <i>P</i>=0.004) was an associated factor for restenosis of the lower extremity arteries after DCB combined with stenting.ROC curve analysis showed that the cut-off value of the external iliac artery calcification score on the stenotic side was 5.5 score, the area under the curve (AUC) for predicting restenosis of lower extremity arteries after DCB combined stent implantation in LEASO patients was 0.818 (95%<i>CI</i>: 0.731-0.904, <i>P</i><0.001), with a sensitivity of 85.4% and a specificity of 68.8%. <b>Conclusions:</b> An elevated calcification score of the external iliac artery on the stenoti
{"title":"[Correlation and predictive value analysis of iliac artery calcification score and restenosis of lower extremity arteries after drug-coated balloon combined with stent implantation in patients with lower extremity atherosclerotic occlusive disease].","authors":"Q H Wang, C Tang, Y M Wang, J Cai, W Wang, F Ran, T Qiao","doi":"10.3760/cma.j.cn112137-20240310-00539","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240310-00539","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the correlation between iliac artery calcification score and restenosis of lower extremity arteries in patients with lower extremity atherosclerotic occlusive disease (LEASO) who underwent drug-coated balloon (DCB) combined with stenting, and to assess the predictive value. <b>Methods:</b> A total of 105 patients with LEASO at Nanjing Drum Tower Hospital, Nanjing University Medicine School, from January 2018 to June 2023 were retrospectively included, and the patients were divided into 2 groups according to whether restenosis of the original lower limb arteries had occurred during follow-up after DCB combined stent implantation: the restenosis group (<i>n</i>=64) and the patency group (<i>n</i>=41). The clinical information of the study subjects was collected through the electronic case system, and all patients underwent CTA examination of both lower limb arteries before the operation, and the calcification scores of common iliac arteries and external iliac arteries of patients' bilateral and stenotic sides were calculated according to the results of the CTA examination. The follow-up time [<i>M</i> (<i>Q</i><sub>1</sub>, <i>Q</i><sub>3</sub>)] was 9.15 (5.67, 15.60) months in the patency group and 9.20 (6.85, 19.65) months in the restenosis group. Univariate and multivariate logistic regression models were used to analyze the factors associated with restenosis after DCB combined with stent implantation in LEASO patients. The predictive value of iliac artery calcification score for postoperative restenosis was assessed using the receiver operating characteristic (ROC) curves. <b>Results:</b> There were 44 males and 20 females in the restenosis group, aged (73±9) years; 31 males and 10 females in the patency group, aged (73±10) years. Compared with the patency group, the restenosis group had higher neutrophil counts, platelet counts, lymphocyte counts, neutrophil-to-lymphocyte ratios (NLR), platelet-to-lymphocyte ratios (PLR), C-reactive protein, fibrinogen, stent lengths, stent numbers, common iliac artery calcification scores (bilateral and stenotic side), and external iliac artery calcification scores (bilateral and stenotic side) (all <i>P</i><0.05). Multifactorial logistic regression analysis showed that higher external iliac artery calcification score on the stenotic side (<i>OR</i>=1.480, 95%<i>CI</i>: 1.130-1.939, <i>P</i>=0.004) was an associated factor for restenosis of the lower extremity arteries after DCB combined with stenting.ROC curve analysis showed that the cut-off value of the external iliac artery calcification score on the stenotic side was 5.5 score, the area under the curve (AUC) for predicting restenosis of lower extremity arteries after DCB combined stent implantation in LEASO patients was 0.818 (95%<i>CI</i>: 0.731-0.904, <i>P</i><0.001), with a sensitivity of 85.4% and a specificity of 68.8%. <b>Conclusions:</b> An elevated calcification score of the external iliac artery on the stenoti","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 37","pages":"3520-3527"},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-08DOI: 10.3760/cma.j.cn112137-20240330-00729
C Li, D Liu, Y H Tian, S M Yuan, L L Wang, X Y Liu
<p><p><b>Objective:</b> To compare the clinical and radiographic outcomes between robot-assisted minimally invasive transforaminal lumbar interbody fusion (RA MIS-TLIF) and fluoroscopy-assisted MIS-TLIF (FA MIS-TLIF) in patients with degenerative lumbar spinal diseases. <b>Methods:</b> The clinical data of 114 patients with lumbar degenerative diseases who underwent MIS-TLIF in Qilu Hospital of Shandong University from January 2019 to March 2022 were analyzed retrospectively. Fifty-eight patients underwent RA MIS-TLIF (robot group) and 56 patients received FA MIS-TLIF (freehand group). There were 16 males and 42 females in the robot group, with a mean age of (56.7±8.1) years. And there were 19 males and 37 females in the freehand group, with a mean age of (57.2±8.6) years. The clinical outcome parameters were the visual analog scale (VAS) of pain, Oswestry Disability Index (ODI) score, operative time, number of intraoperative fluoroscopies, blood loss, postoperative hospital stay and complications. The radiographic change measures were the accuracy of screw placement, facet joint violation (FJV), fusion status, and change in disc height at the proximal adjacent segment. All the patients were followed-up for 2-5 years. <b>Results:</b> There was no significant differences in the VAS and ODI scores, blood loss, or postoperative hospital stay between the two groups (all <i>P</i>>0.05). The operative time was longer in robot group than freehand group [(158.5±12.1) min vs (146.4±15.4) min, <i>P</i><0.001]. There was no significant difference in the number of intraoperative fluoroscopies for patients between robot group and freehand group (<i>P</i>>0.05). The number of intraoperative fluoroscopies for the surgeon was significantly lower in robot group than freehand group (13.8±3.9 vs 74.7±6.8, <i>P</i><0.001). The rate of a perfect screw position (grade A) was higher in robot group than freehand group [87.5%(203/232) vs 70.1%(157/224), <i>P</i><0.001]. However, there was no significant difference in the proportion of clinically acceptable screws (grades A and B) between the two groups [98.3%(228/232) vs 96.9%(217/224), <i>P</i>=0.330]. The FJV grade was significantly higher in freehand group than robot group (0.43±0.68 vs 0.13±0.43, <i>P</i><0.001). During at 2-year postoperative follow-up, there was no significant difference in the fusion status between the two groups (<i>P</i>>0.05); however, the decrease in disc height at the proximal adjacent segment was significantly less in robot group than freehand group [(0.63±0.38) mm vs (0.92±0.35) mm, <i>P</i>=0.001]. In the robotic group, a pedicle screw penetrated the outer wall of the vertebral pedicle in one patient, which was adjusted during surgery. In the freehand group, two screws were inserted too deeply and penetrated the anterior cortex, resulting in mild abdominal discomfort postoperatively, which resolved by the third day after surgery. <b>Conclusions:</b> Robot-assisted percutaneous pedicle scre
目的比较机器人辅助微创经椎间孔腰椎椎体融合术（RA MIS-TLIF）和透视辅助 MIS-TLIF（FA MIS-TLIF）对腰椎退行性疾病患者的临床和影像学疗效。方法：回顾性分析2019年1月至2022年3月在山东大学齐鲁医院接受MIS-TLIF治疗的114例腰椎退行性疾病患者的临床资料。58例患者接受了RA MIS-TLIF（机器人组），56例患者接受了FA MIS-TLIF（徒手组）。机器人组中有16名男性和42名女性，平均年龄为（56.7±8.1）岁。徒手组男性19人，女性37人，平均年龄（57.2±8.6）岁。临床结果指标为疼痛视觉模拟量表（VAS）、Oswestry残疾指数（ODI）评分、手术时间、术中透视次数、失血量、术后住院时间和并发症。影像学变化指标包括螺钉置入的准确性、面关节侵犯（FJV）、融合状态以及近端相邻节段椎间盘高度的变化。所有患者均接受了 2-5 年的随访。结果：两组患者的 VAS 和 ODI 评分、失血量和术后住院时间均无明显差异（P>0.05）。机器人组的手术时间长于徒手组[（158.5±12.1）分钟 vs （146.4±15.4）分钟，PP>0.05]。机器人组术者术中透视次数明显少于徒手组（13.8±3.9 vs 74.7±6.8，PPP=0.330）。徒手组的FJV分级明显高于机器人组（0.43±0.68 vs 0.13±0.43，PP>0.05）；然而，机器人组近端邻近节段椎间盘高度的下降明显少于徒手组[（0.63±0.38）mm vs （0.92±0.35）mm，P=0.001]。在机器人组中，一名患者的椎弓根螺钉穿透了椎弓根外壁，在手术中进行了调整。徒手组中，有两枚螺钉插入过深，穿透了前皮质，导致术后轻微腹部不适，术后第三天即可缓解。结论在MIS-TLIF手术中，机器人辅助经皮椎弓根螺钉置入术比传统的徒手透视辅助椎弓根螺钉置入术更安全、更准确。与徒手 MIS-TLIF 相比，机器人辅助 MIS-TLIF 增加了手术时间，但螺钉置入的准确性更高，术中辐射剂量和邻近节段变性程度也有所降低。
{"title":"[Efficacy comparison of robot-assisted versus freehand fluoroscopy-assisted minimally invasive transforaminal lumbar interbody fusion for degenerative lumbar spinal diseases].","authors":"C Li, D Liu, Y H Tian, S M Yuan, L L Wang, X Y Liu","doi":"10.3760/cma.j.cn112137-20240330-00729","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240330-00729","url":null,"abstract":"<p><p><b>Objective:</b> To compare the clinical and radiographic outcomes between robot-assisted minimally invasive transforaminal lumbar interbody fusion (RA MIS-TLIF) and fluoroscopy-assisted MIS-TLIF (FA MIS-TLIF) in patients with degenerative lumbar spinal diseases. <b>Methods:</b> The clinical data of 114 patients with lumbar degenerative diseases who underwent MIS-TLIF in Qilu Hospital of Shandong University from January 2019 to March 2022 were analyzed retrospectively. Fifty-eight patients underwent RA MIS-TLIF (robot group) and 56 patients received FA MIS-TLIF (freehand group). There were 16 males and 42 females in the robot group, with a mean age of (56.7±8.1) years. And there were 19 males and 37 females in the freehand group, with a mean age of (57.2±8.6) years. The clinical outcome parameters were the visual analog scale (VAS) of pain, Oswestry Disability Index (ODI) score, operative time, number of intraoperative fluoroscopies, blood loss, postoperative hospital stay and complications. The radiographic change measures were the accuracy of screw placement, facet joint violation (FJV), fusion status, and change in disc height at the proximal adjacent segment. All the patients were followed-up for 2-5 years. <b>Results:</b> There was no significant differences in the VAS and ODI scores, blood loss, or postoperative hospital stay between the two groups (all <i>P</i>>0.05). The operative time was longer in robot group than freehand group [(158.5±12.1) min vs (146.4±15.4) min, <i>P</i><0.001]. There was no significant difference in the number of intraoperative fluoroscopies for patients between robot group and freehand group (<i>P</i>>0.05). The number of intraoperative fluoroscopies for the surgeon was significantly lower in robot group than freehand group (13.8±3.9 vs 74.7±6.8, <i>P</i><0.001). The rate of a perfect screw position (grade A) was higher in robot group than freehand group [87.5%(203/232) vs 70.1%(157/224), <i>P</i><0.001]. However, there was no significant difference in the proportion of clinically acceptable screws (grades A and B) between the two groups [98.3%(228/232) vs 96.9%(217/224), <i>P</i>=0.330]. The FJV grade was significantly higher in freehand group than robot group (0.43±0.68 vs 0.13±0.43, <i>P</i><0.001). During at 2-year postoperative follow-up, there was no significant difference in the fusion status between the two groups (<i>P</i>>0.05); however, the decrease in disc height at the proximal adjacent segment was significantly less in robot group than freehand group [(0.63±0.38) mm vs (0.92±0.35) mm, <i>P</i>=0.001]. In the robotic group, a pedicle screw penetrated the outer wall of the vertebral pedicle in one patient, which was adjusted during surgery. In the freehand group, two screws were inserted too deeply and penetrated the anterior cortex, resulting in mild abdominal discomfort postoperatively, which resolved by the third day after surgery. <b>Conclusions:</b> Robot-assisted percutaneous pedicle scre","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 37","pages":"3498-3505"},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-24DOI: 10.3760/cma.j.cn112137-20240401-00756
F L Chi, Z Han
The effects of tinnitus on human health are receiving increasing attention, and it is currently believed that the central compensatory response caused by peripheral hearing loss is the main pathogenesis of chronic tinnitus. Tinnitus, psychological problems and sleep disorders affect and worsen each other, and should be taken seriously in treatment strategies. Chronic tinnitus treatment strategy advocates comprehensive treatment based on sound therapy, including reducing tinnitus sound perception and improving patients' negative mood and poor sleep. Whether treating tinnitus alone or treating relevant psychological problems and sleep disorders can break the vicious circle of tinnitus, psychological problems and sleep disorders. Therefore, balancing both psychological and sleep problems, is the direction of tinnitus treatment and research. The clinical study of the treatment of tinnitus should shift from the previous single tinnitus treatment mode and a single tinnitus evaluation index to the comprehensive treatment and comprehensive evaluation indicators that balance both psychotherapy and sleep improvement.
{"title":"[Focus on the effects of psychological problems and sleep disorders on tinnitus].","authors":"F L Chi, Z Han","doi":"10.3760/cma.j.cn112137-20240401-00756","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240401-00756","url":null,"abstract":"<p><p>The effects of tinnitus on human health are receiving increasing attention, and it is currently believed that the central compensatory response caused by peripheral hearing loss is the main pathogenesis of chronic tinnitus. Tinnitus, psychological problems and sleep disorders affect and worsen each other, and should be taken seriously in treatment strategies. Chronic tinnitus treatment strategy advocates comprehensive treatment based on sound therapy, including reducing tinnitus sound perception and improving patients' negative mood and poor sleep. Whether treating tinnitus alone or treating relevant psychological problems and sleep disorders can break the vicious circle of tinnitus, psychological problems and sleep disorders. Therefore, balancing both psychological and sleep problems, is the direction of tinnitus treatment and research. The clinical study of the treatment of tinnitus should shift from the previous single tinnitus treatment mode and a single tinnitus evaluation index to the comprehensive treatment and comprehensive evaluation indicators that balance both psychotherapy and sleep improvement.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 36","pages":"3367-3370"},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-24DOI: 10.3760/cma.j.cn112137-20240623-01395
M Q Shi, W X Zhang, T Y Ni, C J Lin, N Cong, Y Zheng, B J Chen, S Y Min, R Ma, F L Chi
Objective: To explore the related factors of anxiety and anxiety tendency in patients with tinnitus. Methods: A cross-sectional study was carried out. Basic information, tinnitus characteristics, and psychological status of patients who complained of tinnitus in the Outpatient Department of Eye & ENT Hospital, Fudan University between January 2020 and December 2023 were collected. All patients filled out the self-rating anxiety scale (SAS) and underwent pure tone audiometry testing. According to the SAS scores, patients were divided into three groups: non-anxiety group (SAS<40), anxiety tendency group (40≤SAS<50), and anxiety group (SAS≥50). The related factors of anxiety and anxiety tendency were analyzed using multivariate ordered logistic regression analysis. Results: A total of 176 patients (57 males and 119 females) aged (49.4±10.7) years (range: 13-76 years)were included, with the onset time of 3 days-37 years. There were 78 cases (44.3%), 65 cases (36.9%) and 33 cases (18.8%) in the non-anxiety group, the anxiety tendency group and the anxiety group, respectively. The duration of disease in the anxiety group [(43.4±15.1) months] was significantly longer than that in the anxiety tendency group [(27.2±5.3) months] and the non-anxiety group [(19.6±3.5) months], with statistically significant differences (both P<0.05). The proportion of female patients in the anxiety group [81.8% (27/33)] and anxiety tendency group [75.4% (47/65)] was significantly higher than that in the non-anxiety group [57.7% (45/78)], and the differences were statistically significant (both P<0.05). The proportion of patients with emotional disorders [12.1% (4/33) vs 2.6% (2/78)], stress [15.1% (5/33) vs 3.9% (3/78)], and sleep disorders [48.5% (16/33) vs 23.1% (18/78)] in the anxiety group was significantly higher than that in the non-anxiety group (all P<0.05). The proportion of patients only had sleep disorders in the anxiety tendency group [38.5% (25/65) vs 23.1% (18/78)] was higher than that in the non-anxiety group, with a statistically significant difference (P<0.05). The results of multivariate ordered logistic regression analysis showed that sleep disorders werethe most significant factor affecting anxiety and anxiety tendency in tinnitus patients (OR=2.667, 95%CI: 1.451-4.909, P=0.002). Conclusion: A significant proportion of tinnitus patients exhibit anxiety and anxiety tendency, and sleep disorders play a major role in the development of anxiety and anxiety tendencies in tinnitus patients.
{"title":"[Analysis of factors for anxiety and anxiety tendency in tinnitus patients].","authors":"M Q Shi, W X Zhang, T Y Ni, C J Lin, N Cong, Y Zheng, B J Chen, S Y Min, R Ma, F L Chi","doi":"10.3760/cma.j.cn112137-20240623-01395","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240623-01395","url":null,"abstract":"<p><p><b>Objective:</b> To explore the related factors of anxiety and anxiety tendency in patients with tinnitus. <b>Methods:</b> A cross-sectional study was carried out. Basic information, tinnitus characteristics, and psychological status of patients who complained of tinnitus in the Outpatient Department of Eye & ENT Hospital, Fudan University between January 2020 and December 2023 were collected. All patients filled out the self-rating anxiety scale (SAS) and underwent pure tone audiometry testing. According to the SAS scores, patients were divided into three groups: non-anxiety group (SAS<40), anxiety tendency group (40≤SAS<50), and anxiety group (SAS≥50). The related factors of anxiety and anxiety tendency were analyzed using multivariate ordered logistic regression analysis. <b>Results:</b> A total of 176 patients (57 males and 119 females) aged (49.4±10.7) years (range: 13-76 years)were included, with the onset time of 3 days-37 years. There were 78 cases (44.3%), 65 cases (36.9%) and 33 cases (18.8%) in the non-anxiety group, the anxiety tendency group and the anxiety group, respectively. The duration of disease in the anxiety group [(43.4±15.1) months] was significantly longer than that in the anxiety tendency group [(27.2±5.3) months] and the non-anxiety group [(19.6±3.5) months], with statistically significant differences (both <i>P</i><0.05). The proportion of female patients in the anxiety group [81.8% (27/33)] and anxiety tendency group [75.4% (47/65)] was significantly higher than that in the non-anxiety group [57.7% (45/78)], and the differences were statistically significant (both <i>P</i><0.05). The proportion of patients with emotional disorders [12.1% (4/33) vs 2.6% (2/78)], stress [15.1% (5/33) vs 3.9% (3/78)], and sleep disorders [48.5% (16/33) vs 23.1% (18/78)] in the anxiety group was significantly higher than that in the non-anxiety group (all <i>P</i><0.05). The proportion of patients only had sleep disorders in the anxiety tendency group [38.5% (25/65) vs 23.1% (18/78)] was higher than that in the non-anxiety group, with a statistically significant difference (<i>P</i><0.05). The results of multivariate ordered logistic regression analysis showed that sleep disorders werethe most significant factor affecting anxiety and anxiety tendency in tinnitus patients (<i>OR</i>=2.667, 95%<i>CI</i>: 1.451-4.909, <i>P</i>=0.002). <b>Conclusion:</b> A significant proportion of tinnitus patients exhibit anxiety and anxiety tendency, and sleep disorders play a major role in the development of anxiety and anxiety tendencies in tinnitus patients.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 36","pages":"3392-3396"},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-24DOI: 10.3760/cma.j.cn112137-20240129-00227
T Y Yang, M S W Qumu, X P Li, S Y Wang, J Z He, T Yang
<p><p><b>Objective:</b> To investigate the correlation of body composition indices with exercise capacity and nutritional status in male chronic obstructive pulmonary disease (COPD) patients. <b>Methods:</b> The clinical data of 90 male COPD patients admitted to the Department of Respiratory and Critical Care Medicine of China-Japan Friendship Hospital from January 2021 to September 2022 were retrospectively collected, and the patients were subjected to a pulmonary function test, body composition measurement, 6-minute walking test distance (6MWD) test, and dominant handgrip strength measurement (HGS). The patients were categorized into COPD Global Initiative for COPD (GOLD) grade 1, 2, 3 and 4 groups according to the severity of lung function. Based on the fat-free mass index (FFMI), patients were categorized into a low FFMI group (FFMI<17 kg/m<sup>2</sup>) and a normal FFMI group (FFMI≥17 kg/m<sup>2</sup>). Based on phase angle (PhA), patients were categorized into the low PhA group (PhA<5°) and the normal PhA group (PhA≥5°). Based on 6MWD, patients were divided into impaired endurance group (6MWD<350 m) and normal endurance group (6MWD≥350 m). Differences in body composition indexes, exercise capacity, and nutritional status of patients in different subgroups were compared. A trend test was used to analyze the trend of GOLD grading and body composition indexes. Correlation analysis was used to analyze the correlation of FFMI, PhA, skeletal muscle mass index (SMI), basal metabolic rate (BMR), and visceral fat index (VFI) with 6MWD, HGS, post-diastolic exertional expiratory volume in the first second as a percentage of exertional lung capacity (FEV<sub>1</sub>%pred), and body mass index (BMI). <b>Results:</b> The age of 90 male COPD patients was 66 (59, 71) years. FFMI, PhA, SMI, BMR, VFI, HGS, and 6MWD tended to decrease with increasing GOLD levels (all <i>P</i><0.05). In the low FFMI group (31 cases), PhA [5.0° (4.7°, 5.1°) vs 5.8° (5.6°, 6.3°)], SMI [6.3 (5.3, 6.9)vs 8.3 (7.7, 9.1) kg/m<sup>2</sup>], and BMR [(1 294.5±387.2) vs (1 538.7±207.5) kcal(1 kcal=4.184 kJ)], VFI [(10.0±4.2) grades vs (14.2±3.3) grades], 6MWD [(430.5±90.8) vs (537.2±85.5) m], FEV<sub>1</sub>%pred [(37.8±7.9)% vs (73.7±21.5)%], BMI [(20.2±3.8) vs (25.5±2.9) kg/m<sup>2</sup>] were lower than those in the normal FFMI group (59 cases, all <i>P</i><0.05). In the low PhA group (23 cases), FFMI [(16.7±2.2) vs (19.5±1.5) kg/m<sup>2</sup>], SMI [6.6 (5.9, 7.0) vs 7.3 (7.7, 9.0) kg/m<sup>2</sup>], BMR [(1 251.8±246.2) vs (1 547.5±206.6) kcal], 6MWD [(451.0±47.1) vs (538.3±87.5) m], HGS [(29.6±4.0) vs (36.4±7.2) kg], FEV<sub>1</sub>%pred [(51.2±15.3)% vs (72.9±22.8)%], BMI [(20.9±3.7) vs (25.5±2.8) kg/m<sup>2</sup>] were lower than those of the normal PhA group (67 cases, all <i>P</i><0.05). In the impaired endurance group (21 cases) PhA [5.2° (5.1°, 5.3°) vs 5.8° (5.6°, 6.3°)], FEV<sub>1</sub>%pred [(34.2±15.4)% vs (72.7±22.2)%] were lower than those in the normal endurance grou
{"title":"[Correlation of body composition indicators with exercise capacity and nutritional status in male patients with chronic obstructive pulmonary disease].","authors":"T Y Yang, M S W Qumu, X P Li, S Y Wang, J Z He, T Yang","doi":"10.3760/cma.j.cn112137-20240129-00227","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240129-00227","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the correlation of body composition indices with exercise capacity and nutritional status in male chronic obstructive pulmonary disease (COPD) patients. <b>Methods:</b> The clinical data of 90 male COPD patients admitted to the Department of Respiratory and Critical Care Medicine of China-Japan Friendship Hospital from January 2021 to September 2022 were retrospectively collected, and the patients were subjected to a pulmonary function test, body composition measurement, 6-minute walking test distance (6MWD) test, and dominant handgrip strength measurement (HGS). The patients were categorized into COPD Global Initiative for COPD (GOLD) grade 1, 2, 3 and 4 groups according to the severity of lung function. Based on the fat-free mass index (FFMI), patients were categorized into a low FFMI group (FFMI<17 kg/m<sup>2</sup>) and a normal FFMI group (FFMI≥17 kg/m<sup>2</sup>). Based on phase angle (PhA), patients were categorized into the low PhA group (PhA<5°) and the normal PhA group (PhA≥5°). Based on 6MWD, patients were divided into impaired endurance group (6MWD<350 m) and normal endurance group (6MWD≥350 m). Differences in body composition indexes, exercise capacity, and nutritional status of patients in different subgroups were compared. A trend test was used to analyze the trend of GOLD grading and body composition indexes. Correlation analysis was used to analyze the correlation of FFMI, PhA, skeletal muscle mass index (SMI), basal metabolic rate (BMR), and visceral fat index (VFI) with 6MWD, HGS, post-diastolic exertional expiratory volume in the first second as a percentage of exertional lung capacity (FEV<sub>1</sub>%pred), and body mass index (BMI). <b>Results:</b> The age of 90 male COPD patients was 66 (59, 71) years. FFMI, PhA, SMI, BMR, VFI, HGS, and 6MWD tended to decrease with increasing GOLD levels (all <i>P</i><0.05). In the low FFMI group (31 cases), PhA [5.0° (4.7°, 5.1°) vs 5.8° (5.6°, 6.3°)], SMI [6.3 (5.3, 6.9)vs 8.3 (7.7, 9.1) kg/m<sup>2</sup>], and BMR [(1 294.5±387.2) vs (1 538.7±207.5) kcal(1 kcal=4.184 kJ)], VFI [(10.0±4.2) grades vs (14.2±3.3) grades], 6MWD [(430.5±90.8) vs (537.2±85.5) m], FEV<sub>1</sub>%pred [(37.8±7.9)% vs (73.7±21.5)%], BMI [(20.2±3.8) vs (25.5±2.9) kg/m<sup>2</sup>] were lower than those in the normal FFMI group (59 cases, all <i>P</i><0.05). In the low PhA group (23 cases), FFMI [(16.7±2.2) vs (19.5±1.5) kg/m<sup>2</sup>], SMI [6.6 (5.9, 7.0) vs 7.3 (7.7, 9.0) kg/m<sup>2</sup>], BMR [(1 251.8±246.2) vs (1 547.5±206.6) kcal], 6MWD [(451.0±47.1) vs (538.3±87.5) m], HGS [(29.6±4.0) vs (36.4±7.2) kg], FEV<sub>1</sub>%pred [(51.2±15.3)% vs (72.9±22.8)%], BMI [(20.9±3.7) vs (25.5±2.8) kg/m<sup>2</sup>] were lower than those of the normal PhA group (67 cases, all <i>P</i><0.05). In the impaired endurance group (21 cases) PhA [5.2° (5.1°, 5.3°) vs 5.8° (5.6°, 6.3°)], FEV<sub>1</sub>%pred [(34.2±15.4)% vs (72.7±22.2)%] were lower than those in the normal endurance grou","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 36","pages":"3402-3408"},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-24DOI: 10.3760/cma.j.cn112137-20240220-00356
C Diao, Q Wang, Y Zhao, Z L Meng
Objective: To verify the consistency between changes in Mandarin Tinnitus Questionnaire (MTQ) scores and tinnitus treatment outcomes. Methods: Tinnitus patients attending the Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital of Sichuan University from September 2020 to September 2021were prospectively enrolled. The tinnitus severity was evaluated by the doctor's assessment, the patient's self-assessment, the MTQ, and the Visual Analogue Scale (VAS). Follow-up assessments were conducted 3 to 6 months later to evaluate the severity of tinnitus post-treatment, and information on the interventions received (pharmacologic/non-pharmacologic) and patients' self-reported clinical impressions of their treatment outcomes (tinnitus cured/improved/no change/exacerbated) was collected. Results: A total of 54 tinnitus patients aged (43.5±12.7) years were included, consisting of 16 males and 38 females. There were 38 cases in the medication group and 16 cases in the non-medication group. No statistically significant differences in baseline clinical data were observed (all P>0.05). The proportion of primary tinnitus in the medication group was higher than that in the non-medication group [97.4% (37/38) vs 75.0% (12/16), P=0.023]. The correlation coefficients of MTQ scores at the initial and follow-up visits with doctor's assessment, patient's self-assessment, and VAS scores were 0.679, 0.483, 0.606, 0.774, 0.779, and 0.756, respectively (all P<0.001). The ΔMTQ correlation coefficient with ΔVAS was 0.694 (P<0.001), with a mean difference of 3.704×10-7 and 95% limits of agreement ranging from -1.534 to 1.534 in Bland-Altman analysis. There were no statistically significant differences of ΔVAS and ΔMTQ between two groups (both P>0.05). Conclusions: MTQ correlates well with the doctor's assessment, the patient's self-assessment, and VAS. Changes in MTQ scores associate well with changes in VAS scores. Additionally, changes in MTQ scores are consistent with the effect of tinnitus treatment.
{"title":"[The consistency between changes in Mandarin Tinnitus Questionnaire scores and tinnitus treatment outcomes].","authors":"C Diao, Q Wang, Y Zhao, Z L Meng","doi":"10.3760/cma.j.cn112137-20240220-00356","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240220-00356","url":null,"abstract":"<p><p><b>Objective:</b> To verify the consistency between changes in Mandarin Tinnitus Questionnaire (MTQ) scores and tinnitus treatment outcomes. <b>Methods:</b> Tinnitus patients attending the Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital of Sichuan University from September 2020 to September 2021were prospectively enrolled. The tinnitus severity was evaluated by the doctor's assessment, the patient's self-assessment, the MTQ, and the Visual Analogue Scale (VAS). Follow-up assessments were conducted 3 to 6 months later to evaluate the severity of tinnitus post-treatment, and information on the interventions received (pharmacologic/non-pharmacologic) and patients' self-reported clinical impressions of their treatment outcomes (tinnitus cured/improved/no change/exacerbated) was collected. <b>Results:</b> A total of 54 tinnitus patients aged (43.5±12.7) years were included, consisting of 16 males and 38 females. There were 38 cases in the medication group and 16 cases in the non-medication group. No statistically significant differences in baseline clinical data were observed (all <i>P</i>>0.05). The proportion of primary tinnitus in the medication group was higher than that in the non-medication group [97.4% (37/38) vs 75.0% (12/16), <i>P</i>=0.023]. The correlation coefficients of MTQ scores at the initial and follow-up visits with doctor's assessment, patient's self-assessment, and VAS scores were 0.679, 0.483, 0.606, 0.774, 0.779, and 0.756, respectively (all <i>P</i><0.001). The ΔMTQ correlation coefficient with ΔVAS was 0.694 (<i>P</i><0.001), with a mean difference of 3.704×10<sup>-7</sup> and 95% limits of agreement ranging from -1.534 to 1.534 in Bland-Altman analysis. There were no statistically significant differences of ΔVAS and ΔMTQ between two groups (both <i>P</i>>0.05). <b>Conclusions:</b> MTQ correlates well with the doctor's assessment, the patient's self-assessment, and VAS. Changes in MTQ scores associate well with changes in VAS scores. Additionally, changes in MTQ scores are consistent with the effect of tinnitus treatment.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 36","pages":"3386-3391"},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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