Objective To design a new extracorporeal reduction device for percutaneous pedicle screw fixation of thoracolumbar fractures (short for “new reduction device”), and to evaluate its effectiveness. Methods According to the mechanism of thoracolumbar fractures and biomechanics characteristic of reduction, a new reduction device was designed and used in a combination with long U-shaped hollow pedicle screw system. Between January 2014 and January 2016, 36 patients (group A) with single segment thoracolumbar fracture without neurological complications underwent percutaneous pedicle screw fixation, and the clinical data were compared with those of another 39 patients (group B) with thoracolumbar fracture underwent traditional open pedicle screw fixation. There was no significant difference in gender, age, cause of injury, classification of fractures, segments of fractures, injury to operation interval, height percentage of injury vertebrae, and kyphotic angle between 2 groups (P>0.05). The 2 groups were compared in terms of operation time, length of incision, intraoperative blood loss, drainage volume, visual analogue scale (VAS) at postoperative 24 hours, fluoroscopy frequency, ambulation time, height percentage of injury vertebrae, kyphotic angle and correction. Results Group A was significantly better than group B in the operation time, length of incision, intraoperative blood loss, drainage volume, VAS score at postoperative 24 hours, and ambulation time (P<0.05). However, fluoroscopy frequency of group B was significantly less than that of group A (P<0.05). All patients were followed up 11.2 months on average (range, 7-15 months). There was no intraoperative and postoperative complications of iatrogenic nerve injury, infection, breakage of internal fixation. Mild pulling-out of pedicle screws occurred in 1 case of group A during operation. The kyphotic angle and height percentage of the fractured vertebral body were significantly improved at 3 days after operation when compared with preoperative ones (P<0.05), but no significant difference was found between 2 groups at 3 days after operation (P>0.05). Conclusion Minimally invasive extracorporeal reduction device for percutaneous pedicle screw fixation is an effective and safe treatment of thoracic vertebrae and lumbar vertebrae fractures, because of little trauma, less bleeding, and quicker recovery.
【Abstract】 Objective To survey the prevalence and risk factors of chronic obstructive pulmonary disease ( COPD) , and establish database for community intervention of COPD.Methods A cluster-randomsampling survey was carried out. The population aged over 40 years old in eight communities of Chengdu were investigated from August 2007 to August 2009 using the standard protocol and questionnaire. The spirometry was performed for each participant. Results A total of 4315 residents were enrolled in this survey and 3687 case reports were analyzed, including 1529 males and 2148 females, with an average age of 60. 35 ±13. 21 years old. Total prevalence of COPD was 9. 6% . The prevalence of COPD in the males was significantly higher than that in the females ( 14. 0% vs. 6. 4%, P lt;0. 01) . The prevalence of COPD increased with the age. The major risk factors were cigarettes smoking ( OR = 3. 012, 95% CI 2. 390-3. 797, P lt; 0. 01) and indoor cooking smoking ( OR = 2. 546, 95% CI 1. 734-3. 425, P lt; 0. 01) . Conclusion The prevalence of COPD in Chengdu city is significantly higher than average level of the whole country, which warrant moreattention to better prevention and treatment of COPD in communities.
Objective To survey the prevalence of coexisting chronic obstructive pulmonary disease ( COPD) and chronic heart failure in Chengdu communities. Methods A cross-sectional study was performed in the population aged over 40 years in eight communities of Chengdu city. The subjects were selected by stratified cluster random sampling. Using the same protocol and questionnaire, all participants underwent medical history taking, physical examination and spirometry. Results Of 354 participating patients with a diagnosis of COPD, 74 ( 20. 90% ) cases were complicated with chronic heart failure. The prevalence of chronic heart failure in COPD in male was significantly higher than that in female ( 22. 69%vs. 18. 12% , P lt; 0. 05) . The major causes of chronic heart failure were hypertension ( 31. 64% ) , ischaemic heart disease ( 18. 93% ) , chronic pulonary heart disease ( 17. 51% ) and diabetes ( 11. 86% ) .Conclusions The prevalence of coexisting COPD and chronic heart failure in Chengdu city is significantly higher than the average level of the whole country, which warrant more attention in prevention and treatment of COPD in communities.