Short-term efficacy of digitally-assisted traditional Chinese medicine manual reduction combined with 3D printed splint in the treatment of AO type-A distal radius fractures / 中国骨伤

Objective To explore the short-term efficacy of digitally-assisted traditional Chinese medicine manual reduction combined with 3D printed splint in the treatment of AO type-A distal radius fractures, and explore the quantification of traditional Chinese medicine manual reduction and personalized improvement of splinting. Methods The clinical data of 50 patients with AO type-A distal radius fractures, who received treatment at the outpatient department of Cangzhou Integrated Traditional Chinese and Western Medicine Hospital in Hebei Province, were retrospective analyzed. The patient cohort included 22 females and 28 males, with ages ranging from 25 to 75 years old. Among them, 27 cases presented with distal radius fractures on the left side, and 24 cases on the right side. The patients were categorized into two groups: treatment group (n=25) and control group(n=25). There were 13 males and 12 females in the treatment group, with an average age of (56.2±5.5) years old. Treatment approach for this group involved several steps. Initially, Mimics Research software was used to conduct comprehensive analysis of complete CT data from the affected limb, resulting in the creation of a three-dimensional model. Subsequently, 3D models of the bones and skin contours, stored as STL format files, were imported into the Materialise Magics 23.0 software for model processing and repair. This facilitated the simulation of reduction and recording of displacement data, effectively generating a "digital prescription" to guide and quantify traditional Chinese medicine manipulation procedures. Finally, a personalized 3D printed splint was applied for fixation treatment. There were 15 males and 10 females in the control group, with an average age of (53.32±5.28) years old. These patients were treated with manualreduction combined with traditional splinting. The clinical efficacy of the two groups was assessed in terms of fracture reduction quality, fracture healing time, Gartland-Werley wrist joint score and X-ray parameters (palminclination angle, ulnar deviation angle, radius height) at 6 weeks post-operatively. Results The treatment group exhibited a shorter duration for achieving clinical healing compared to the control group (P<0.05). Six weeks post-operatively, the treatment group demonstrated higher wrist joint function scores, and a higher proportion of excellent and good outcomes than the control group(P<0.05). The treatment group was superior to the control group in terms of imaging parameters 6 weeks post-operatively (P<0.05). Conclusion By quantifying skin contours through digital simulation prescription reduction, a personalized 3D printed splint is developed to effectively stabilize fractures, enhancing localized fixation while ensuring greater adherence, stability, and comfort. This innovative approach offers personalized treatment for AO type-A distal radius fractures and presents a novel, precise treatment strategy for consideration.

Field epidemiological study on a varicella outbreak among schoolchildren in Shenzhen / 中华流行病学杂志

Objective Both epidemiologic characteristics and transmission mode of a varicella outbreak among schoolchildren in Shenzhen city were studied and related control measures were discussed.Methods Case definition was established.Case-finding and face-to-face investigation were conducted,followed by analysis on distributions of time,place and persons of the outbreak.Association between possible modes of transmission and the outbreak was explored.Retrospective cohort study was carried out.Results The overall attack rate of this outbreak was 4.4％ (122 of 2742).The attack rate among primary schoolchildren (8.3％,118/1419) was higher than that in the middle-school children (0.3％,4/1323).There were no statistically significant differences on the attack rates between male and female students.A total of 22 classes from the 9 grades were affected by this outbreak and the aggregation of varicella cases was found in classes.The highest attack rates was found in the students of fifth grade (23.7％),followed by from the third grade (13.4％).The main transmission mode appeared to be close personal contact.The outbreak,with four peaks of incidence,lasted 72 days.Data from the investigation suggested that the primary case was introduced into the school during military training involved by the students.Activities related to physical examination for all the schoolchildren seemed to have contributed to the spread of this disease among classes.Delayed isolation of cases appeared to be the major factor causing the spread of disease among classes.Intensive off-school activities or free community bus for children did not seem to be associated with the spreading of the disease.52.5％ (64/122) of the cases had received one-dose of varicella vaccine,with the median of onset after the vaccination as 7 years.The results demonstrated that one single-dose vaccine or long vaccination period were factors related to the insufficient immunity that causing the outbreak of disease.Conclusion Varicella outbreak has been one of the most grievous public health problems in schools,posting challenges on the implementation of isolation measures,in particular.Once the chain of transmission is in place,it is difficult to make the universal measures effective within a short period.