OBJECTIVE: To discuss the causes and treatments of wound infections after scoliosis surgery. METHODS: Nine hundred and twenty-four caes of scoliosis were reviewed, and the clinical data of 15 cases of postoperative in...OBJECTIVE: To discuss the causes and treatments of wound infections after scoliosis surgery. METHODS: Nine hundred and twenty-four caes of scoliosis were reviewed, and the clinical data of 15 cases of postoperative infection were analysed retrospectively. RESULTS: All 15 cases underwent spinal posterior fusion with autologous bone graft using instrumentations. Seven were diagnosed as early infection, and 8 were delayed infection. Radical debridement was performed in all 15 cases. The duration of antibiotics administration was 10 to 34 days with continuous closed irrigation for 2 to approximately 4 weeks and primary closure for the wounds. All patients were followed up for an average of 3.5 years (2 to 7.5 years) with good outcomes and no recurrence. CONCLUSION: Wound infection following surgical correction of scoliosis primarily results from intraoperative seeding, although host-related and operation-related factors may contribute to its development. Once the infections are diagnosed, good results can be achieved by prompt surgical debridement, irrigation and reasonably administered antibiotics. Removal of hardware may be necessary in deep infections.展开更多
Objective To explore the diagnosis and treatment features of tuberous sclerosis complex associated renal cell carcinoma. Methods A 22-year-old boy with a childhood history of epilepsy and mental retardation pres-
Sixty-four patients receiving therapeutic ERCP were reported. The patients were divided into three groups. Group 1, endoscopic sphincterotomy (n = 28); Group 2, Nasobiliary catheter (n = 25); Group 3, Biliary endopros...Sixty-four patients receiving therapeutic ERCP were reported. The patients were divided into three groups. Group 1, endoscopic sphincterotomy (n = 28); Group 2, Nasobiliary catheter (n = 25); Group 3, Biliary endoprosthesis (n=11).展开更多
Background： Case management is a term used to describe the activities performed by a physician or other health care professional to ensure the coordination of medical services required by a patient. Managed care requ...Background： Case management is a term used to describe the activities performed by a physician or other health care professional to ensure the coordination of medical services required by a patient. Managed care requires the incorporation of information pertaining to patient evaluation, treatment planning, referrals, and follow-up care to ensure that payment for services is received and that care is ongoing and comprehensive. The objective of this review was to assess the efficacy of case management in patients with type 2 diabetes mellitus with respect to outcomes such as glycosylated hemoglobin （HbA1c）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, and low-density lipoprotein （LDL）. Methods： Databases including PubMed, Embase, Web of Science, the Cochrane Library, the China Na- tional Knowledge Infrastructure （CNKI）, VIP, Wan Fang and the Chinese Biomedical Literature Database （CBM） were searched for randomized controlled trials （RCTs） dating as late as Jan, 2015, Reference sections of the included studies were also searched. Results： Twelve studies, involving 11 RCTs that evaluated a total of 4000 patients, were included in this analysis. Two of the 12 studies evaluated the same RCT. Seven of the 12 studies reported HbAlc as an outcome, and three trials reported changes in SBP, DBP and LDL levels as outcomes. The pooled results indicated that statistically significant improvements in HbAlc （MD = -0.35, 95% CI （-0.68, -0,02）, P = 0.04） and LDL levels （MD = -2,49, 95% CI （-4.04, -0.93）, P - 0.002） were associated with the case management group compared with control group; however, no statistically significant differences in DBP （MD = -0.08, 95% CI （-0.68, 0.52）, P = 0.8） and SBP （MD = -0.96, 95% CI （ 5.77, 3.84）, P = 0.69） were observed. Conclusions： Case management was effective in improving HbA1c and LDL levels in patients with type 2 diabetes mellitus. Although no statistically significant differences in DBP and SBP between the case management group and the control group were observed, further research is required to draw a conclusion about the effect of managed care on these outcomes. Based on this meta-analysis of clinical trials, we conclude that case management offers an effective clinical method for the treatment of type 2 diabetes.展开更多
文摘OBJECTIVE: To discuss the causes and treatments of wound infections after scoliosis surgery. METHODS: Nine hundred and twenty-four caes of scoliosis were reviewed, and the clinical data of 15 cases of postoperative infection were analysed retrospectively. RESULTS: All 15 cases underwent spinal posterior fusion with autologous bone graft using instrumentations. Seven were diagnosed as early infection, and 8 were delayed infection. Radical debridement was performed in all 15 cases. The duration of antibiotics administration was 10 to 34 days with continuous closed irrigation for 2 to approximately 4 weeks and primary closure for the wounds. All patients were followed up for an average of 3.5 years (2 to 7.5 years) with good outcomes and no recurrence. CONCLUSION: Wound infection following surgical correction of scoliosis primarily results from intraoperative seeding, although host-related and operation-related factors may contribute to its development. Once the infections are diagnosed, good results can be achieved by prompt surgical debridement, irrigation and reasonably administered antibiotics. Removal of hardware may be necessary in deep infections.
文摘Objective To explore the diagnosis and treatment features of tuberous sclerosis complex associated renal cell carcinoma. Methods A 22-year-old boy with a childhood history of epilepsy and mental retardation pres-
文摘Sixty-four patients receiving therapeutic ERCP were reported. The patients were divided into three groups. Group 1, endoscopic sphincterotomy (n = 28); Group 2, Nasobiliary catheter (n = 25); Group 3, Biliary endoprosthesis (n=11).
文摘Background： Case management is a term used to describe the activities performed by a physician or other health care professional to ensure the coordination of medical services required by a patient. Managed care requires the incorporation of information pertaining to patient evaluation, treatment planning, referrals, and follow-up care to ensure that payment for services is received and that care is ongoing and comprehensive. The objective of this review was to assess the efficacy of case management in patients with type 2 diabetes mellitus with respect to outcomes such as glycosylated hemoglobin （HbA1c）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, and low-density lipoprotein （LDL）. Methods： Databases including PubMed, Embase, Web of Science, the Cochrane Library, the China Na- tional Knowledge Infrastructure （CNKI）, VIP, Wan Fang and the Chinese Biomedical Literature Database （CBM） were searched for randomized controlled trials （RCTs） dating as late as Jan, 2015, Reference sections of the included studies were also searched. Results： Twelve studies, involving 11 RCTs that evaluated a total of 4000 patients, were included in this analysis. Two of the 12 studies evaluated the same RCT. Seven of the 12 studies reported HbAlc as an outcome, and three trials reported changes in SBP, DBP and LDL levels as outcomes. The pooled results indicated that statistically significant improvements in HbAlc （MD = -0.35, 95% CI （-0.68, -0,02）, P = 0.04） and LDL levels （MD = -2,49, 95% CI （-4.04, -0.93）, P - 0.002） were associated with the case management group compared with control group; however, no statistically significant differences in DBP （MD = -0.08, 95% CI （-0.68, 0.52）, P = 0.8） and SBP （MD = -0.96, 95% CI （ 5.77, 3.84）, P = 0.69） were observed. Conclusions： Case management was effective in improving HbA1c and LDL levels in patients with type 2 diabetes mellitus. Although no statistically significant differences in DBP and SBP between the case management group and the control group were observed, further research is required to draw a conclusion about the effect of managed care on these outcomes. Based on this meta-analysis of clinical trials, we conclude that case management offers an effective clinical method for the treatment of type 2 diabetes.
