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Objective:To compare clinical outcomes of arthroscopic double-row anchor suture bridge fixation versus open reduction and internal plating in the treatment of simple humeral fracture of the greater tuberosity.Methods:From March 2013 to March 2017 at Department of Orthopaedics, Jianhu Hospital Affiliated to Nantong University, 40 patients were treated for simple humeral fracture of the greater tuberosity. They were 23 men and 17 women, aged from 25 to 70 years (mean, 53.2 years). All the fracture displacements were larger than 5 mm and the fracture blocks smaller than 3 cm × 3 cm. They were complicated with no other injuries like rotator cuff tear, superior labrum anterior posterior (SLAP) injury or Bankart injury. Of them, 18 were treated by arthroscopic double-row anchor suture bridge fixation and 22 by open reduction and internal plating. The 2 groups were compared postoperatively in terms of joint activity, visual analogue scale (VAS) pain score, American Shoulder and Elbow Surgeon (ASES) score at the last follow-up.Results:There were no significant differences in the preoperative general data between the 2 groups ( P>0.05), indicating they were comparable. The arthroscopy and open reduction groups were followed up for an average of 19 and 20 months, respectively. All the patients obtained bony union within 3 months after surgery. At the last follow-up for the arthroscopy and open reduction groups, respectively, the shoulder flexion was 152.7°±13.3° and 137.7°±19.2°, the abduction 146.0°±16.4° and 132.4°±20.5°, the VAS score 0.8±0.4 and 1.3±0.6 and the ASES score 91.8±4.1 and 87.4±5.8, showing significant differences in the above items between the 2 groups ( P<0.05). In the open reduction group, 2 patients developed subacromial impingement syndrome which was relieved after removal of the plate following fracture union. Shoulder stiffness was observed in one case but improved after manipulative release under anesthesia. Conclusion:In the treatment of simple humeral fracture of the greater tuberosity, arthroscopic double-row anchor suture fixation has advantages over open reduction and internal plating because it can lead to less invasion, quicker recovery and better functional recovery of the shoulder after operation.
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Objective Researching the influence on patients with different eating ways after the operation of mandibular angle osteotomy of inside oral cavity. Method By using the method of convenience sampling, 50 patients were chosen who had operation of mandibular angle osteotomy of inside oral cavity in orthopedic surgery department of our hospital from January 2017 to December 2017 and the number was arranged according to the order of hospitalization. Patients with singular member were divided into the month feeding group (liquid diet were fed with the injection syringe which linked leather hose of 4-5cm after 6 hours awakening after general anesthesia in operation); patients with even number were divided into the nasal feeding group (stomach tube was put in the operation and nasal feeding was provided after 6 hours awakening after general anesthesia in operation and 5 hours after the operation). In every group, there were 25 patients. Observation scale which was made by themselves was used to evaluate the patients in the two groups and comparison for difference was made in the two groups, including weight change, wound drainage amount, oral wound secretion, the aspects of choke and cough, and the comfortable sensation of eating. Results For weight, in nasal feeding group, (2.19 ± 0.48) kg were reduced and in month feeding group, (5.78 ± 0.58) kg were reduced; the difference had the statistical significance (t＝23.870, P<0.05). For wound drainage amount, in nasal feeding group, the number was (38.00 ± 11.00)ml and in month feeding group, the number was (65.00 ± 13.00) ml, the difference was statistically significant (t＝7.927, P<0.01). In the aspects of choke and cough, and wound secreta in oral cavity, in nasal feeding group, the number were 16% (4/25) and 44% (11/25) respectively which was superior to the month feeding group with the number of 44% (11/25) and 76% (19/25), the difference had the statistical significance (χ2＝4.667, 5.333, P<0.05). For the comfortable sensation of eating, in the two groups, there was no significant statistical difference (χ2＝0.764, P>0.05). Conclusion The nasal feeding way can improve recovery level for patients after the operation of mandibular angle osteotomy of inside oral cavity and it is worthy of promotion in clinic application.
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Objective@#To explore the effects of transcutaneous electrical acupoint stimulation (TEAS) on pain of patients in expansion process of skin soft tissue dilator on forehead by water injection.@*Methods@#From June 2016 to June 2017, 100 patients in expansion process of skin soft tissue dilator on forehead by water injection meeting the inclusion criteria were admitted to Outpatient Department of Orthopedic Surgery of Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine. There were 43 men and 57 women among the patients, aged 27 to 55 years, and the prospective randomized controlled study was performed on them. The patients were divided into TEAS nursing group and routine nursing group according to the random number table, with 50 patients in each group. Patients in routine nursing group were performed with routine nursing in every water injection in outpatient department and 2 days later. On the basis of routine nursing, patients in TEAS nursing group were performed with TEAS treatment by responsible nurses in each water injection in outpatient department. The Shangxing, Diwei, and Hegu points were positioned accurately, and electrical stimulation was performed on the 3 points simultaneously by pulse acupuncture treatment instrument, with 30 minutes each time. Two days after every water injection of outpatient department, TEAS nursing was performed at home by patients and their family members under remote guidance of the responsible nurses, with 2 times each day and 30 minutes each time. Besides, follow-up was done by phone by the responsible nurses everyday. The nursing of patients in the 2 groups lasted the whole expansion process. After the expansion process, the overall pain degree and the most severe pain degree of patients during expansion process were scored by numerical rating scale, and the overall comfort degree and its dimensions of patients during expansion process were scored by the responsible nurses every day by simplified Comfort Status Scale. Data were processed with independent sample t test and chi-square test.@*Results@#During expansion process, the overall pain score degree and the most severe pain degree score of patients in TEAS nursing group were (5.4±1.2) and (6.5±1.0) points, which were significantly lower than (6.1±1.3) and (7.5±1.4) points of patients in routine nursing group (t=-2.62, -4.00, P<0.05 or P<0.01). During expansion process, the physiological dimension, sociocultural dimension, psychological spirit dimension, environmental dimension, and total score of the overall comfort degree of patients in TEAS nursing group were (9.6±2.9), (20.1±2.8), (29.1±1.9), (22±3), and (80±6) points, significantly higher than (5.7±2.1), (16.8±2.8), (26.0±2.8), (21±4), and (69±8) points of patients in routine nursing group (t=8.03, 6.35, 7.60, 2.11, 10.64, P<0.05 or P<0.01).@*Conclusions@#TEAS with appropriate intensity, frequency, and duration can alleviate the pain of patients during expansion process of skin soft tissue dilator on forehead by water injection and improve their comfort degree.
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Objective@#Researching the influence on patients with different eating ways after the operation of mandibular angle osteotomy of inside oral cavity.@*Method@#By using the method of convenience sampling, 50 patients were chosen who had operation of mandibular angle osteotomy of inside oral cavity in orthopedic surgery department of our hospital from January 2017 to December 2017 and the number was arranged according to the order of hospitalization. Patients with singular member were divided into the month feeding group (liquid diet were fed with the injection syringe which linked leather hose of 4-5cm after 6 hours awakening after general anesthesia in operation); patients with even number were divided into the nasal feeding group (stomach tube was put in the operation and nasal feeding was provided after 6 hours awakening after general anesthesia in operation and 5 hours after the operation). In every group, there were 25 patients. Observation scale which was made by themselves was used to evaluate the patients in the two groups and comparison for difference was made in the two groups, including weight change, wound drainage amount, oral wound secretion, the aspects of choke and cough, and the comfortable sensation of eating.@*Results@#For weight, in nasal feeding group, (2.19±0.48) kg were reduced and in month feeding group, (5.78±0.58) kg were reduced; the difference had the statistical significance (t=23.870, P<0.05). For wound drainage amount, in nasal feeding group, the number was(38.00±11.00)ml and in month feeding group, the number was (65.00±13.00) ml, the difference was statistically significant (t=7.927, P<0.01). In the aspects of choke and cough, and wound secreta in oral cavity, in nasal feeding group, the number were 16% (4/25) and 44% (11/25) respectively which was superior to the month feeding group with the number of 44% (11/25) and 76% (19/25), the difference had the statistical significance (χ2=4.667, 5.333, P<0.05). For the comfortable sensation of eating, in the two groups, there was no significant statistical difference (χ2=0.764, P>0.05).@*Conclusion@#The nasal feeding way can improve recovery level for patients after the operation of mandibular angle osteotomy of inside oral cavity and it is worthy of promotion in clinic application.
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Objective To investigate the effect of flipped classroom based on WeChat and mi-crolecture in medical chemistry experiment course in the context of "internet". Methods The classes were randomly divided into 2 groups, experimental group (flipped classroom teaching, n=97) and the control group (traditional teaching, n=98). Comparison of the chemistry experiment test results were performed with the use of t test between the two teaching groups at the end of the semester to evaluate the experimental teaching method. All statistical processing and analyses were performed with SPSS software (version 12.0). Results The chemistry experiment test score of the experimental group was higher than that of the control group [(77.84±8.22) vs. (73.43±10.14), t=3.341, P=0.008), and the difference was statistically significant. The results of the questionnaire showed that the students in the experimental group generally consider that flipped classroom teaching is better than the traditional teaching in terms of the cultivation of comprehen-sive quality and the teaching effect. Conclusion In the context of "internet", flipped classroom teaching with WeChat microlecture can better mobilize the enthusiasm of students to learn and participate in medical chemistry experiment course, which has been welcomed by students and further suggest good application prospects.
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This study explores the teaching effect on theoretical-experimental integrationteaching reform in sanitary chemistry experiment. We carry out various kinds of teaching method in sanitary chemistry experiment by aspects such as theoretical and experimental course package arrange-ment, the module integration of theory and experiment. The practice shows thattheoretical-experimen-tal integration teaching reform practice can improve the quality of sanitary chemistry experiment teaching and cultivate students' comprehensive quality.