Visual Analogue Scale Score In Group Research Articles

Comparative Efficacy of Topical Metronidazole and Glyceryl Trinitrate Versus Topical Glyceryl Trinitrate Alone in the Treatment of Acute Anal Fissure: A Randomized Clinical Trial.

Background and objective An anal fissureis a longitudinal, oval lesion in the anal canal. In over 90% of instances, the anal fissures are located posterior to the midline and produce discomfort upon defecation and/or bleeding owing to spasms of the internal anal sphincter that leads to ischemia. This research aimed to determine if topical metronidazole treatment when combined with glyceryl trinitrate 0.2% (GTN), is more successful than GTN alone in reducing the time for an acute anal fissure to heal. Material and methods This study was a single-blinded, randomized controlled trial conducted at the DHQ Hospital Okara from January 2022 to August 2022. Patients of both genders, aged 18 to 70 years, with acute anal fissures, were included. One hundred forty patients who satisfied the inclusion criteria were randomized through the lottery technique and were divided into two groups (70 in each group). Group A contained patients who got metronidazole combination with GTN, while in Group B, patients treated with GTN alone without metronidazole. The primary endpoint was fissure healing, confirmed as finding a scar where the fissure was. While the secondary endpoint was maximum pain on defecation assessed by the Visual Analogue Scale (VAS). Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) v24. Chi-Square and Fisher's Exact tests were done for statistical analysis, and p < 0.05 was considered significant. Results Three patients lost the follow-up. Out of the remaining 137, 70 (51.1%) patients were male. The patient's ages ranged from 22 to 68 years, with a mean age of 39.18 ± 11.52. One hundred twenty six (92%) complained of pain on defecation with a mean VAS of 6.01 ± 2.35. 80 (58.4%) patients complained of perianal itching, while 25 (18.2%) patients complained of bleeding on defecation. On week 1 follow-up, in group A out of 69 patients, 27 (39.1%) had complete healing, 38 (55.1%) had partial healing, while in group B out of 68 patients, one (1.4%) had complete healing, 43 (63.2%) had partial healing (p = < 0.001, significant). On week 3 follow-up, in group A out of 69 patients, 47 (68.1%) had complete healing, and 22 (31.8%) had partial healing, while in group B out of 68 patients, 16 (23.5%) had complete healing, 49 (72%) had partial healing (p = < 0.001, significant). Mean VAS score of group A was 0.61 ± 1.38 while that of group B was 2.57 ± 2.50 (p = < 0.001, significant). Conclusion Using topical metronidazole as an addition to standard therapy may reduce the chronicity of acute anal fissures and prevent surgical treatments with high rates of complications.

High-frequency repetitive transcranial magnetic stimulation of the left dorsolateral prefrontal cortex reduces drug craving and improves decision-making ability in methamphetamine use disorder

Methamphetamine abuse is escalating worldwide. Its strong and irreversible neurotoxicity generally causes structural and functional changes in the brain. Repetitive transcranial magnetic stimulation (rTMS) as a non-invasive tool can be used to modulate neuronal activity, cortical excitability, and dopaminergic neurotransmission. This study aims to explore the efficacy of high-frequency rTMS in reducing drug craving and increasing decision-making ability for methamphetamine use disorder patients. Sixty-four methamphetamine use disorder patients were randomized to sham rTMS group and 10-Hz rTMS group. Visual analog scale (VAS) and Iowa game test (IGT) were used to evaluate drug craving and cognitive decision-making ability before and after treatment. Before the treatment, the two groups had no differences in the scores of VAS and IGT. After the intervention, VAS scores of 10-Hz rTMS group were significantly lower than that of sham rTMS group. In addition, the two groups had significant differences in the net score of IGT on block 4 and block 5, which favoured the 10-Hz rTMS group. Taken together, the present results suggest that High-frequency rTMS can be used to reduce drug craving and improve decision-making function for methamphetamine use disorder.

Oblique lateral interbody fusion stand-alone vs. combined with percutaneous pedicle screw fixation in the treatment of discogenic low back pain.

ObjectiveOblique lateral interbody fusion (OLIF) has unique advantages in the treatment of discogenic low back pain (DBP). However, there are few studies in this area, and no established standard for additional posterior internal fixation. The purpose of this study was to investigate the efficacy of OLIF stand-alone vs. combined with percutaneous pedicle screw fixation (PPSF) in the treatment of DBP.MethodsThis retrospective case-control study included forty patients. All patients were diagnosed with DBP by discography and discoblock. Perioperative parameters (surgery duration, blood loss, and muscle damage), complications, Visual analog scale (VAS), and Oswestry Disability Index (ODI) were assessed. Imaging data including cage subsidence, cage retropulsion, fusion rate, and adjacent spondylosis degeneration (ASD) were analyzed.ResultsThere were 23 patients in the OLIF stand-alone group and 17 patients in the OLIF + PPSF group. The mean surgery duration, blood loss, and muscle damage in the OLIF stand-alone group were significantly better than those in the OLIF + PPSF group (P < 0.05). However, there was no significant difference in the average hospitalization time between the two groups (P > 0.05). There was no significant difference in the VAS and ODI scores between the two groups before surgery (P > 0.05), and VAS and ODI scores significantly improved after surgery (P < 0.05). The VAS and ODI scores in the OLIF stand-alone group were significantly better than those in the OLIF + PPSF group at 1 month (P < 0.05), While there was no significant difference between the two groups at 12 months and last follow up (P > 0.05). At the last follow-up, there was no significant difference in cage subsidence, fusion rate, ASD and complication rate between the two groups (P > 0.05).ConclusionOLIF stand-alone and OLIF + PPSF are both safe and effective in the treatment of DBP, and there is no significant difference in the long-term clinical and radiological outcomes. OLIF stand-alone has the advantages of surgery duration, blood loss, muscle damage, and early clinical effect. More clinical data are needed to confirm the effect of OLIF stand-alone on cage subsidence and ASD. This study provides a basis for the clinical application of standard DBP treatment with OLIF.

Effect of a combination of general anesthesia and superficial cervical plexus block with ropivacaine on patients undergoing thyroidectomy

Purpose: To investigate the effect of a combination of general anesthesia and superficial cervical plexus block (SCPB) with ropivacaine on patients undergoing thyroidectomy.&#x0D; Methods: Ninety-six (96) patients undergoing thyroidectomy were randomly divided into control and study group. Both groups were subjected to SCPB in combination with general anesthesia. Ropivacaine was used for SCPB in the study group. Vital signs, visual analogue scale (VAS) scores, and serum interleukin 1β (IL-1β) levels were determined at various time points (T) after tracheal intubation. Occurrence of adverse reactions was recorded.&#x0D; Results: Compared with the control group, mean arterial pressure (MAP), heart rate (HR), diastolic blood pressure (DBP), and systolic blood pressure (SBP) levels from T1 to T5 were declined in study group (p &lt; 0.01). VAS scores of study group were significantly lower at 12, 24, and 48 h after thyroidectomy than in control group (p &lt; 0.05). At 5, 10 and 15 h after surgery, serum IL-1β level in study group was down-regulated (p &lt; 0.05). Moreover, a marked decrease in the incidence of adverse reactions was also found in the study group post-surgery (p &lt; 0.05).&#x0D; Conclusion: Ropivacaine is effective for SCPB in combination with general anesthesia in patients undergoing thyroidectomy. It is safer and more feasible in SCPB when combined with general anesthesia. However, further clinical trials are required to validate this technique.

A Pilot Analysis on the Efficacy of Multiple Trigger-Point Saline Injections in Chronic Tension-Type Headache: A Retrospective Observational Study.

This study aimed to investigate the efficacy of new targeted trigger-point injections (TPIs) using isotonic saline in patients with chronic tension-type headache (CTTH). Of 121 patients with headache who were retrospectively reviewed, 19 were included in this study and were categorized into two groups: those who received TPIs more than four times (group 1); and those who received TPIs less than, or equal to, four times (group 2). The patients received ultrasound-guided isotonic saline injections into the active trigger points once weekly. The primary outcome was an effect on headache intensity, determined using the visual analog scale (VAS), whereas the secondary outcome was an effect on quality of life, evaluated using the Henry Ford Hospital Headache Disability Inventory (HDI). The mean symptom duration of the 19 patients (11 men and 8 women; mean age, 52.5 years; and range, 23–81 years) was 16 months. The most frequently injected muscle was the splenius capitis. Patient demographics were similar between the two groups (p > 0.05). Simple linear regression revealed that symptom duration (p = 0.001) and baseline VAS score (p = 0.009) were significantly associated with the number of injections. At one month after the first injection, the mean VAS and HDI scores in group 2 were significantly lower than those in group 1 (p < 0.05), whereas the scores significantly decreased immediately after the last injection in both groups (p < 0.05). No adverse effects were reported in any patient. Our results indicate that the administration of new targeted TPIs using isotonic saline into the head and neck muscles of patients with CTTH can effectively relieve headache intensity and safely improve their quality of life.

Analysis of the Application Effect of Exercise Rehabilitation Therapy Based on Data Mining in the Prevention and Treatment of Knee Osteoarthritis.

Objective To analyze the application effect of exercise rehabilitation therapy based on data mining in the prevention and treatment of knee osteoarthritis. Methods Based on clinical data mining technology, that is, using complex network technology and association rules, the medical records of 1612 patients with KOA in the Department of Rheumatology and Immunology of our hospital were retrospectively analyzed, and they were divided into groups according to whether they used exercise rehabilitation therapy (n = 786), and the control treatment group (n = 826), the curative effect, the improvement of inflammatory factors and immune factors, the visual analogue scale (VAS), the knee joint function score (Lysholm), and the quality of life (WOMAC) scale were compared between the two groups score, analyze the relationship between VAS and Lysholm score and prognosis quality of life, and compare the recurrence within 12 months between the two groups. Results The data mining results showed that the curative effect of the exercise rehabilitation therapy group was significantly higher than that of the control treatment group (P < 0.05); the improvement of VAS and Lysholm scores of the exercise rehabilitation therapy group was significantly better than that of the control treatment group (P < 0.05). The improvement effect of inflammatory indexes and immune cytokines was significantly better than that of the control treatment group (P < 0.05); the improvement of WOMAC in the exercise rehabilitation therapy group was significantly better than that of the control treatment group (P < 0.05); VAS and WOMAC scores were significantly positively correlated (r = 0.579, P < 0.05); Lysholm score was positively correlated with WOMAC score (r = −0.563, P < 0.05); the recurrence rate of exercise rehabilitation therapy group was 5.09%, which was significantly lower than that of control treatment group (17.63% (χ2 = 11.967), P < 0.05). Conclusion Exercise rehabilitation therapy for KOA patients can effectively improve inflammatory and immune factors in patients, enhance knee joint function and prognosis quality of life, and reduce readmission rate, which is worthy of clinical application.

Investigation of the 12-month efficacy and safety of low-dose mifepristone in the treatment of painful adenomyosis

Objective: To study the 12-month effects and possible mechanisms of low-dose mifepristone in the treatment of adenomyosis. Methods: Patients included in this retrospective study had painful adenomyosis and previously received 5 mg mifepristone daily (group A, n = 45) or 5 mg mifepristone daily with a poor-effect levonorgestrel-releasing intrauterine device (group B, n = 13) for 12 months. Uterine size, serum CA125 levels, estradiol levels, Visual Analogue Scale (VAS) score, endometrial thickness, and hemoglobin levels were compared before and after treatment and investigated again at 3 to 6 months after drug withdrawal. Another 8 patients with adenomyosis (group C, n = 8) who underwent surgery for severe dysmenorrhea during the same period were only used as a control group for immunohistochemical research. Endometrial biopsy results and expression of nerve growth factor (NGF), cyclooxygenase-2 (COX-2), and nuclear-associated antigen Ki-67 (Ki-67) in endometrial tissues and adenomyotic lesions were also analyzed. Results: The VAS scores in both experimental groups at all time points during treatment and follow-up were significantly lower (P &lt;0.001) than those before treatment. The uterine size was significantly reduced, and endometrial thickness was distinctly thicker after 12 months of treatment than that before treatment in group A receiving 5 mg/d mifepristone. The immunohistochemical expression of NGF and COX-2 decreased in both eutopic and ectopic endometrium after treatment, whereas that of Ki-67 slightly increased in eutopic endometrium after treatment and rapidly recovered to the baseline value after stopping mifepristone. There were no signs of hyperplasia, atypical hyperplasia, or malignancy in the endometrial biopsies. Conclusions: The results suggested that a daily dose of 5 mg mifepristone for 12 months down-regulated the expression of NGF and COX-2 and was effective in treating painful adenomyosis with few side effects.

Effect of Human-Oriented Fine Nursing on Psychological Emotion, Life Quality, and Nursing Satisfaction of Patients Undergoing Laparoscopic Radical Nephrectomy.

Purpose This study set out to explore the therapeutic effects of human-oriented fine nursing intervention on patients undergoing laparoscopic radical nephrectomy and its influence on patients' quality of life. Methods A total of 120 patients who underwent laparoscopic radical nephrectomy in Sheng Jing Hospital of China Medical University from January 2019 to January 2020 were randomized into group A (n = 60) and group B (n = 60) by the random table method. Group B was treated with routine nursing while group A was additionally treated with human-oriented fine nursing. Meanwhile, the study compared the two groups in terms of vital signs, postoperative recovery time, visual analogue scale (VAS), sleep quality (SQ), adverse psychological response score, and quality of life (QOL). Results According to our findings, patients of group A had significantly lower heart rate, blood pressure, and adverse psychological response scores compared to those of group B; the postoperative recovery time of group A was considerably shorter than that of group B; the VAS scores of group A at 3 and 6 days after surgery were markedly lower than those of group B; group A had a remarkably higher number of patients with excellent postoperative SQ than group B; and group A saw substantially higher QOL scores of patients compared to group B. Conclusion Results of this study suggested that fine nursing intervention based on humanistic care for patients undergoing laparoscopic radical nephrectomy can improve the physical condition of patients, refine their mentalities, and improve their sleep quality, thus enhancing their quality of life and accelerating the recovery process. Therefore, this nursing mode is worthy of promotion and application in clinical practice.

Efficacy of Autologous Intra-articular Platelet Rich Plasma Injection as a Biological Adjuvant in Early Primary Osteoarthrosis Knee—A Prospective Study

Introduction Classical characteristics of osteoarthrosis are reduction or loss of articular cartilage, new bone formation, accompanied by synovial proliferation resulting in pain, loss of joint function, and disability. Platelet rich plasma (PRP) has been used to provide stimulus for local regeneration and healing. The present study was conducted with the aim of evaluating the clinical outcome and efficacy of injecting PRP intra-articularly in early primary osterarthrosis knee. Objective Prospective study was conducted with the aim of evaluating the clinical outcome of efficacy of injection of PRP in early primary osteoarthrosis knee with respect to pain, stiffness, function and quality of life, in short-term follow-up. Attempt was made to standardize protocol and formulate PRP. Materials and Methods Patients were divided into two groups: one treated with two autologous PRP injections at 2 weeks interval and second received symptomatic treatment with physiotherapy. Patients were prospectively evaluated at baseline and then at 1 month, 3 months, and 6 months of follow-up using the visual analog scale (VAS) score, Western Ontario and McMaster Universities osteoarthritis index (WOMAC) score, and range of movements. Results There was reduction in VAS score in group 1 patients compared with group 2 patients with the p-value &lt;0.0001 which was highly significant. There was a significant improvement in WOMAC score at 1 month, 3 months, and 6 months in group 1 compared with group 2 patients. Conclusion Autologous PRP in osteoarthrosis of knee has emerged as a simple technique, sensitive procedure, and cost-effective treatment option. Administration of intra-articular PRP injections reduced the VAS score significantly and also a significant improvement in the WOMAC score was observed in patients who were treated with PRP injection. The two doses of injection of PRP were found to give adequate relief in short term of 6 months and further long-term studies are required.

Influence of Different Surgical Timing after Percutaneous Kyphoplasty for Osteoporotic Vertebral Compression Fractures: A Retrospective Study.

Background A large number of people suffer from osteoporotic vertebral compression fractures (OVCFs) worldwide. Percutaneous kyphoplasty (PKP), considered a minimally invasive surgery, has been widely used to treat OVCFs and achieves satisfactory outcomes. However, the surgical timing of PKP is still under discussion. Methods A total of 149 patients were enrolled in the study and were divided into 3 groups according to different surgical timing. Group A (n = 52) included patients who required emergency surgery. Group B (n = 50) included patients who required surgery around a week after injury. Group C (n = 47) included patients who required surgery a month or more after injury. Characteristics of patients and radiological images were recorded. The Visual Analog Scale (VAS) scores and the Oswestry Disability Index (ODI) scores were analyzed before, 1 day, 1 month, and 6 months after surgery. In addition, compression rates of anterior vertebral height (AVH) were calculated and the kyphosis Cobb angle was measured before and after surgery. Results There was a significant difference in the VAS and ODI scores between the three groups at 1 day, 1 month, and 6 months after PKP. The VAS and ODI scores of Group C were higher than those of Groups A and B. The AVH compression rates of Group C were significantly higher than those of Groups A and B postoperatively 1 day, 1 month, and 6 months. The kyphosis Cobb angles in Group C was significantly larger than those in Groups A and B at 1 day and 1 month after PKP. Conclusions Emergency PKP showed more advantages in both clinical and radiological outcomes. We recommend early PKP for the treatment of OVCFs.

Lisfranc injuries with dislocation the first tarsometatarsal joint: primary arthrodesis or internal fixation (a randomized controlled trial).

Open reduction and internal fixation (ORIF) is a popular method for treatment of displaced Lisfranc injuries. However, even with anatomic reduction and solid internal fixation, treatment does not provide good outcomes in certain severe dislocations. The purpose of this study was to compare ORIF and primary arthrodesis (PA) of the first tarsometatarsal (TMT) joint for Lisfranc injuries with the first TMT joint dislocation. Seventy-eight Lisfranc injuries with first TMT joint dislocation were finally enrolled and analyzed in a prospective, randomized trial comparing ORIF and PA. They were 50 males and females with a mean age of 40.7years and randomized to ORIF group and PA group. Outcome measures included radiographs, American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scale, Foot and Ankle Ability Measure (FAAM) Sports subscale, visual analog scale (VAS), and the 36-Item Short Form Health Survey (SF-36). Complications and revision rate were also analyzed. Forty patients were treated by ORIF, while PA group includes 38 cases. Patients were followed up for 37.8(range, 24-48) months. At final follow-up, the mean AOFAS midfoot score (P < 0.01), the FAAM Sports subscale (P < 0.01), the physical function score (P < 0.05), and the Bodily Pain score of SF-36 (P < 0.05) after ORIF treatment were significantly lower than PA group. The mean VAS score in ORIF group was higher (P < 0.01). In ORIF group, redislocation of the first TMT joint was observed in ten cases, and thirteen patients had pain in midfoot. No redislocation and no hardware failure were identified in PA group. PA of the first TMT joint provided a better medium-term outcome than ORIF for Lisfranc injuries with the first TMT dislocation. Possible complications and revision could be avoided by PA for dislocated first ray injuries.

Effects of Epidural Analgesia on Labor Pain and Course of Labor in Primigravid Parturients: A Prospective Non-randomized Comparative Study.

Background and aim: The aim of this study was to compare the effects of epidural analgesia on relief of labor pain, progress, and outcome of labor in primigravid parturients to those who did not receive any analgesia.Methods: This was a hospital-based, quasi-experimental study conducted on 70 primigravid parturients at term with a single fetus in a cephalic presentation in active labor. Parturients who were willing to receive epidural analgesia formed group S (n=35) and parturients who refused epidural analgesia formed group C (n=35). The primary objective was to compare alleviation of pain measured by the Visual Analogue Scale (VAS) score. Secondary objectives were to compare the duration of labor, mode of delivery, and neonatal outcome.Results: Pain intensity was significantly lower in group S compared to group C at all measured points of time (p<0.001). There was a quick fall in mean VAS score in group S from 7.94 to 3.86 within 20 min with the bolus dose, it further dropped to 1.03 after 3 h. Further, 88.6% of parturients in groups rated their pain relief as excellent and good satisfaction score. Prolongation of active phase of the first stage of labor (>6 h) was not significant (17.1 % in epidural group versus 5.7% in control group; p=0.259). However, prolongation of the second stage of labor (> 2h) was significant (18.2% in study group versus 0% in control group; p=0.024). The rate of cesarean section, instrumental vaginal delivery, and neonatal outcome was similar in both groups. No adverse effects were observed on maternal vitals, fetal heart rate and Apgar score at 5 min.Conclusion: Epidural analgesia alleviated labor pain in all primigravid parturients who opted for it, without an increase in cesarean section and instrumental vaginal birth. Improved parturients' satisfaction with associated neonatal safety provides a positive birth experience. There was no effect on duration of active phase of the first stage of labor, but the duration of the second stage of labor was slightly prolonged.

Efficacy comparison and safety analysis of subcutaneous specific immunotherapy with standardized house dust mite allergen in patients with single and multiple allergic rhinitis

Efficacy comparison and safety analysis of subcutaneous specific immunotherapy with standardized house dust mite allergen in patients with single and multiple allergic rhinitis

Pulsed Radiofrequency Combined With Methylene Blue Paravertebral Nerve Block Effectively Treats Thoracic Postherpetic Neuralgia.

ObjectiveTo compare the effect, safety, and patient satisfaction of pulsed radiofrequency combined with methylene blue paravertebral nerve block and pulsed radiofrequency alone in the treatment of thoracic postherpetic neuralgia (PHN).MethodsA total of seventy-two patients with PHN diagnosed in the Department of Pain Management of Shengjing Hospital at China Medical University, from September 2019 to April 2021, were enrolled in the study. Patients were randomly divided into two groups. Group A (n = 36) received pulsed radiofrequency treatment. Group B (n = 36) received pulsed radiofrequency + methylene blue paravertebral nerve block. Patients were followed-up at 1 day, 1 week, 1 month, 3 months, and 6 months after treatment. Observation at each follow-up included basic patient characteristics, Visual Analog Scale (VAS), Hospital Anxiety and Depression Scale (HAD), the Insomnia Severity Index (ISI), patient satisfaction, complications, and side effects.ResultsCompared with preoperative values, the VAS scores significantly decreased in both groups at each postoperative time point (1 day, 1 week, and 1, 3, and 6 months; all p < 0.05). Compared with group A, VAS scores in group B were significantly lower 1 week and 1 month after surgery (p < 0.05). Patients in group B had lower HAD scores than those in group A 1 week after surgery (p < 0.05). Patients in group B had lower ISI scores than those in group A 1 day, 1 week, and 1, 3, and 6 months after surgery (p < 0.05). The pregabalin dosage in group B was lower than that in group A at 1 and 6 months after surgery (p < 0.05). Patient satisfaction was higher in group B than in group A at 1 week and 6 months after surgery (p < 0.05). There were no serious complications or side effects in either group.ConclusionPulsed radiofrequency combined with methylene blue paravertebral nerve block is superior to pulsed radiofrequency alone in the treatment of thoracic PHN, which can significantly relieve PHN and improve the condition of sleep and emotional disorders. Therefore, it is a safe and effective treatment method.

Clinical Efficacy of Cervical Core Strengthening Exercise in the Treatment of Cervicogenic Headache

<bold>Objective</bold> To explore the clinical efficacy of cervical core strengthening exercise in the treatment of cervicogenic headache. <bold>Methods</bold> A total of 168 patients with cervicogenic headache who visited Rehabilitation Medicine Department of Beijing Jishuitan Hospital from January 2016 to December 2017 were randomly divided into control group and treatment group using a random number table sampling method, with 84 cases in each group. The patients in the control group were treated with conventional treatment, including taking rest, treating with therapeutic modalities, oral drugs. Therapeutic modalities included ultrashort wave, interferential current therapy, laser, magnetic therapy (15 minutes per time, once per day). On the other hand, drug therapy included nonsteroidal anti-inflammatory drugs, eperisone hydrochloride and gabapentin, etc. In addition of the conventional treatment, the treatment group also participated in strengthening exercise of anterior, posterior and lateral core muscles of cervical vertebra (each movement held for 10 seconds, 20 movements at a time, and 5 sets of exercise per day) for 4 weeks. Furthermore, it was changed to 2 sets of exercise per day for 12 months. In addition, visual analog scale (VAS) score, Hamilton's Depression Scale-17 (HAMD-17), Pittsburgh Sleep Quality Index (PSQI) and Patients' Global Impression of Change (PGIC) scale were evaluated before treatment and at 1 month, 3 months and 12 months of treatment. <bold>Results</bold> In terms of the intragroup comparison, the VAS score in control group improved at 1 month of treatment compared with that before treatment (<italic>P</italic>&lt;0.05). There were no significant changes in each index at each time point (<italic>P</italic>&gt;0.05). By contrast, the VAS, HAMD-17, PSQI and PGIC scores in the treatment group improved at 1 month, 3 months and 12 months of treatment compared with those before treatment (<italic>P</italic>&lt;0.05). The comparison between groups showed that no significant differences were found in VAS, HAMD-17, PSQI and PGIC scores between the two groups at 1 month of treatment (<italic>P</italic>&gt;0.05). Apart from that, the VAS, HAMD-17, PSQI and PGIC scores in the treatment group improved more than those in the control group at 3 months and 12 months of treatment (<italic>P</italic>&lt;0.05). Specifically, at 3 months of treatment, the scores of the treatment group were VAS (2.96±1.11), HAMD-17 (25.95±5.91), PSQI (4.55±0.81), and PGIC (4.87±1.47), while the scores of the control group were VAS (5.86±1.31), HAMD-17 (36.97±7.62), PSQI (6.97±1.21), and PGIC (2.36±0.74), and the difference was statistically significant respectively (<italic>P</italic>&lt;0.05). Last, at 12 months of treatment, the treatment group's VAS (1.92±0.91), HAMD-17 (21.94±7.52), PSQI (2.32±0.61), and PGIC (5.50±1.41) were better than the control group's VAS (6.97±1.01), HAMD-17 (41.38±9.02), PSQI (5.15±1.11), and PGIC (2.50±0.91), and the difference was statistically significant respectively (<italic>P</italic>&lt;0.05). <bold>Conclusion</bold> The cervical core strengthening exercise will relieve pain, improve scores of mood and sleep in patients with cervicogenic headache.

Clinical study of awake prone positioning treatment in patients with common coronavirus disease 2019 caused by Omicron variant

To evaluate the clinical effect of awake prone positioning (APP) for common coronavirus disease 2019 (COVID-19) caused by Omicron variant. Retrospectively analyze the clinical data of patients with COVID-19 caused by Omicron variant admitted by medical team of Tianjin Third Central Hospital during the period of supporting Tianjin COVID-19 designated hospital from January 8 to February 20, 2022. Patients who met the diagnostic criteria for common COVID-19 and had risk factors for developing severe disease or had pulse oxygen saturation (SpO2) ≤ 0.93 after exercise without supplementary oxygen were enrolled. Patients were divided into APP group and control group according to whether they completed the daily 12-hours APP in the first three days after enrollment. Demographic characteristics, clinical symptoms, COVID-19 vaccination status, laboratory examination, disease progression (progression to severe), time to nucleic acid negative conversion, length of hospital stay, and adverse reactions and tolerability [visual analog scale (VAS) score (the higher the score, the worse the tolerability] during APP were evaluated in two groups. Interleukin-6 (IL-6), C-reactive protein (CRP), SpO2/inhaled oxygen concentration (FiO2) ratio and ROX index (ROXI) were compared between two groups at enrollment, 3rd and 7th day after enrollment. There were no significant differences in demographic characteristics, clinical symptoms, vaccination rates of COVID-19 and laboratory tests between the two groups. There were no statistically significant differences in IL-6, CRP, SpO2/FiO2 ratio and ROXI between two groups at the time of enrollment. Compared with the group at the time of enrollment, SpO2/FiO2 ratio and ROXI in APP group increased significantly at the 3rd day after enrollment [SpO2/FiO2 ratio: 461.90 (457.10, 466.70) vs. 446.67 (437.14, 457.10), ROXI: 25.40 (23.33, 25.93) vs. 22.57 (21.86, 24.40), all P < 0.05], and the levels of IL-6 and CRP in control group were significantly increased [IL-6 (ng/L): 18.30 (6.50, 37.75) vs. 7.40 (5.10, 11.15), CRP (mg/L): 11.46 (2.11, 17.96) vs. 4.11 (1.72, 9.05), all P < 0.05]. At the 3rd day of enrollment, the levels of IL-6 and CRP in APP group were significantly lower than those in control group [IL-6 (ng/L): 7.35 (4.35, 12.80) vs. 18.30 (6.50, 37.75), CRP (mg/L): 4.52 (1.98, 9.66) vs. 11.46 (2.11, 17.96), all P < 0.05], while SpO2/FiO2 ratio and ROXI were significantly higher than those in control group [SpO2/FiO2 ratio: 461.90 (457.10, 466.70) vs. 446.67 (441.90, 459.52), ROXI: 25.40 (23.33, 25.93) vs. 23.31 (22.10, 24.66), all P < 0.05]. At the 7th day of enrollment,there were no significant differences in IL-6, CRP, SpO2/FiO2 ratio and ROXI between two groups. There were no severe cases in both groups. The time of nucleic acid negative conversion and length of hospital stay in APP group were significantly shorter than those in control group [10.0 (8.0, 12.0) days vs. 11.0 (9.0, 13.0) days, 12.0 (10.0, 14.0) days vs. 14.0 (12.0,16.0) days, respectively, all P < 0.05]. The main adverse reaction during APP was back pain, and the incidence in APP group was slightly lower than that in control group, but the difference was not statistically significant [17.9% (17/95) vs. 26.5% (27/102), P = 0.149]. VAS score in control group was significantly higher than that in APP group [score: 2.5 (2.0, 4.0) vs. 2.0 (1.0, 3.0), P = 0.004]. In common COVID-19 patients caused by Omicron variant with high risk factors for progression to severe disease or decreased oxygen reserve capacity, early APP can shorten the time of nucleic acid negative conversion and the length of hospital stay, but its effect on preventing disease progression cannot be determined.

Efficacy comparison of zero-profile intervertebral fusion and stand-alone interbody cage combined with cage-titanium plate construct in treatment of two-segment skip cervical spondylosis

Objective: To investigate the difference in clinical efficacy between zero-profile interbody fusion (ROI-C) and stand-alone interbody cage combined with cage-titanium plate construct for patient with two-segment skipped cervical spondylosis who received the anterior cervical discectomy and fusion (ACDF) surgical strategies. Methods: The clinical data of 62 patients with two-segment skipped cervical spondylosis who underwent surgical treatment in the First Affiliated Hospital of Zhengzhou University from June 2017 to June 2020 were retrospectively analyzed, included 38 males and 24 females, aged (53.3±8.5) years. Thirty-three cases were treated with ROI-C (ROI-C group), and 29 cases with stand-alone interbody cage combined with cage-titanium plate construct (cage+titanium plate group). The following parameters, including operation time, intraoperative blood loss, dysphagia Bazaz grade, Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS) of pain, neck disability index (NDI), average intervertebral height of operated segments, C2-7 Cobb angle, and related complications, were compared between the two groups. Results: The patients were followed up for (28±5) months (16-34 months). The operation time of ROI-C group was (127.6±34.2) min, which was shorter than that in cage+titanium plate group [(157.1±43.9) min, P=0.004]. The scores of JOA and VAS in both ROI-C group and cage+titanium plate group were significantly improved 3 months after operation when compared with those before operation, and there was no significant difference between the two groups (all P>0.05). The average intervertebral space height of fusion segment in ROI-C group was (6.02±1.03) mm before operation, it was improved to (8.38±1.47) mm at 3 months after operation, (8.16±1.40) mm at 12 months after operation, and it was (6.24±1.05) mm, (8.58±1.18) mm and (7.87±0.73) mm in cage+titanium plate group, respectively, and there was no significant difference between the two groups at each time point (all P>0.05). The Cobb angle of cervical vertebrae in ROI-C group was 10.5°±6.8° before operation, improved to 19.2°±9.0° at 3 months after operation, 18.2°±5.8° at 12 months after operation, and it was 10.9°±4.6°, 18.5°±7.8°, 17.1°±5.2° in cage+titanium plate group, respectively, and there was no significant difference between the two groups at each time point (all P>0.05). The incidence of postoperative dysphagia was 9.1%(3/33) in the ROI-C group and 37.9%(11/29) in the cage+titanium plate group, and the difference was statistically significant (P=0.007). Conclusions: Both ROI-C and stand-alone interbody cage combined with cage-titanium plate construct can achieve good results for two-segment skipped cervical spondylosis. However, ROI-C is more advantageous in shortening the operation time and reducing early postoperative dysphagia.

Comparison of treatment effects between 4.9% N-acetyl-aspartyl glutamic acid and 0.05% cyclosporine A eye drops in dry eye patients.

We aimed to investigate the difference in the treatment effects of 4.9% N-acetyl-aspartyl glutamic acid (NAAGA) and 0.05% cyclosporine A (CsA) eye drops in dry eye patients. We retrospectively reviewed the medical records of 86 patients (86 eyes) who were diagnosed with dry eye and treated with NAAGA or CsA eye drops. Patients treated with NAAGA or CsA eye drops were designated as group A or B, respectively. We also calculated Ocular Surface Disease Index (OSDI), dry eye, and meibomian gland dysfunction (MGD) parameters before treatment and at 1 and 3months after treatment. Eye drop discomfort was assessed by calculating visual analog scale (VAS) scores at 1month and 3months after treatment. There were no significant differences in patients' demographics and OSDI, dry eye, and MGD parameters between the two groups. OSDI, dry eye, and MGD parameters at 1month and 3months after treatment were found to be improved in both groups. However, at 1month after treatment, the dry eye and MGD parameters of group A, except for corneal fluorescein staining, showed more improvement than those of group B. Additionally, at 3months after treatment, the lid margin abnormality score, corneal staining score, tear break-up time, and OSDI of group A were significantly lower than those of group B. VAS scores of group A at 1 and 3months after treatment were significantly lower than those of group B. Treatment with NAAGA eye drops was effective in dry eye patients and demonstrated faster treatment response and less discomfort during application than CsA eye drops.

One-stage freehand minimally invasive pedicle screw fixation combined with mini-access surgery through OLIF approach for the treatment of lumbar tuberculosis

ObjectiveTo compare one-stage freehand minimally invasive pedicle screw fixation (freehand MIPS) combined with mini-access surgery through OLIF approach with posterior approach for treatment of lumbar tuberculosis (TB), and evaluate its feasibility, efficacy and safety in debridement, bone graft fusion and internal fixation.Methods48 patients with single segment lumbar TB from June 2014 to June 2017 were included. Among them, 22 patients underwent one-stage freehand MIPS combined with mini-access surgery through OLIF approach (group 1), 26 patients were treated with posterior open surgery (group 2). Duration of operation, blood loss, and stay time in hospital were compared. Pre- and postoperative visual analog scale (VAS) pain scores, Oswestry disability index (ODI), erythrocyte sedimentation rate, complications and images were also recorded.ResultsPatients in group 1 showed significantly less blood loss (165 ± 73 ml vs 873 ± 318 ml, P < 0.001), shorter stay time in hospital (6/4–8 days vs 12/8–15 days, P < 0.001), while longer duration of operation (185 ± 14 min vs 171 ± 12 min, P < 0.001) than group 2 did. VAS scores significantly decreased after surgery in both groups, however, VAS scores of group 1 were significantly lower than that of group 2 immediately after surgery and during follow-ups (P < 0.001). ODI of group 1 was also significantly lower than that of group 2 at 12-month after surgery (P < 0.001).ConclusionOne-stage freehand MIPS combined with mini-access surgery through OLIF approach is a feasible, efficient and safe method in treating single segment lumbar TB. It shows advantages of less surgical trauma and faster postoperative recovery.

Effects of Silicone Mattress Combined with Hydrocolloid Dressing on Pressure Ulcers and Phlebitis in ICU Patients with Liver Failure.

Objective This study was aimed at clarifying the application effect of silicone mattress combined with hydrocolloid dressing in ICU patients with liver failure. Methods A total of 86 patients with liver failure admitted to the intensive care unit (ICU) of the Fifth Medical Center of Chinese PLA General Hospital from September 2018 to September 2020 were selected as the research subjects. Patients treated with conventional sponge mattress and routine nursing care were included in group A (n = 43), and those treated with silicone mattress combined with hydrocolloid dressing were included in group B (n = 43). The incidence of pressure ulcers and phlebitis, the scores of Visual Analogue Scale (VAS) and Pittsburgh Sleep Quality Index (PSQI), and the nursing satisfaction were observed and compared between the two groups. Results The incidence of pressure ulcers in group B (6.98%) was lower than that in group A (25.58%). The incidence of phlebitis in group B was lower than that in group A (20.93% vs. 53.49%). The VAS score of group B was 2.16 ± 0.38, which was lower than that of group A (4.86 ± 1.09). The PSQI score of group B was lower than that of group A (9.74 ± 2.76 vs. 14.84 ± 3.95). A higher nursing satisfaction was determined in group B compared with group A (93.02% vs. 76.74%). Conclusions Silicone mattress combined with hydrocolloid dressing can reduce the incidence of pressure ulcers and phlebitis in ICU patients with liver failure, reduce complications, and improve nursing satisfaction, which is worthy of clinical promotion.