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The paper retrieves SCI papers related to medical treatment cloud and analyzes the current research direction of this topic.It makes the bibliometric analysis of SCI papers on this topic in Web of Science TM core integrated database,counts up the occurrence frequency of high-frequency subject terms in the same document and generates the co-occurrence matrix.By clustering analysis of various document contents in the matrix with SPSS,it obtains the research direction of this topic.
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<p><b>OBJECTIVE</b>To study the difference in pathologic diagnostic accuracy among different histologic subtypes of osteosarcoma and different methods of preoperative biopsy, and the influence of diagnostic accuracy on prognosis of osteosarcoma.</p><p><b>METHODS</b>The preoperative biopsies, complete clinical, radiological and pathological data of 347 pathologically confirmed osteosarcomas were evaluated. According to the Pathological Diagnostic and Technical Specifications, the accuracy of preoperative biopsies was divided into 6 grades. 1: definite diagnosis, 2: basically definite diagnosis, 3: significant diagnosis, 4: descriptive diagnosis, 5:inadequate sampling, 6:misdiagnosis. 1 to 3 were defined as successful diagnosis,while 4 to 6 were defined as unsuccessful diagnosis.</p><p><b>RESULTS</b>Of the 347 biopsies, 252 were CT-guided needle biopsies by the radiologists, and 95 were core-needle biopsies by orthopedic surgeons without CT-guidance. The latter showed a higher overall biopsy success rate (97.9%) in all osteosarcomas. Biopsies by surgeons showed a higher biopsy success rate (95.4%) in conventional osteosarcoma, but lower success rate in telangiectatic (55.6%) and low-grade central osteosarcomas (63.7%). The accuracy of pathologic diagnosis of preoperative biopsy was related to patients' age, serum AKP level, imaging diagnosis, method of biopsy and the subtype of osteosarcoma. Comparing the groups with successful and unsuccessful diagnosis, there were significant differences in recurrence rate and mortality after operation (P<0.01).</p><p><b>CONCLUSIONS</b>The accuracy of pathologic diagnosis of preoperative biopsy are related to recurrence rate and mortality after operation. Biopsy by orthopedic surgeons without CT-guidance is reliable and safe, followed by primary diagnosis at frozen section and final diagnosis by routine pathologic sections for osteosarcomas located in the long bones of the extremities. Close integration of the preoperative pathologic diagnosis with clinical and radiological data will improve the accuracy of diagnosis.</p>
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The paper analyzes SCI papers on metabolic diseases in the field of nutrition published from 2010 to 2015 in the core col-lective database of Web of Science TM by use of the co-word clustering method .It extracts high-frequency subject headings , generates the co-occurrence matrix and makes clustering analysis of the matrix with SPSS , and indicates that major research focuses in this field are researches on metabolic syndrome from different angles such as the cardiovascular disease , insulin resistance , risk factors of the coro-nary disease, body mass index, the obesity group and adipose tissue , etc.
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The paper uses bibliometrics method to analyze literatures in Web of ScienceTM relevant to remote medical education pub-lished from 2005 to 2015 and carries out cluster analysis, works out the main research directions in recent 10 years including evaluation of remote medical education in light of META Analysis;utilization of remoted medicine technology in continuing medical education;dis-cussion on the route, approach and experience of developing remote medical education; the method to enhance the medical care level, improve health of the patients and further raise their life quality.
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Objectives To evaluate the preliminary effectiveness,investigate the clinical methods and prevent the complications of the epiphysis preservation operation by using custom-made prosthesis in children with distal femoral osteosarcomas.Methods Between August 2012 and July 2013,3 patients (from 8 to 14 years old) who were diagnosed of osteosarcoma underwent tumor segmental resection and epiphysis preservation operation and reconstruction with custom-made prosthesis.Patients were assigned neoadjuvant chemotherapy 1 to 2 cycles.The effect of neoadjuvant chemotherapy was then evaluated by X-ray,CT and MRI.Patients were determined the disease field by MRI,customized prosthesis by computer and had surgery of tumor segmental resection and reconstruction with custom-made prosthesis.All individuals were given appropriate functional exercise after operation,standard chemotherapy after incision healing one week,and long-time follow-ups.Results The operation times were 3 hours,4 hours and 6 hours.The bleeding losses during operation were 300 ml,500 ml and 2200 ml,respectively.The functional scores according to the scoring system of the Musculoskeletal Tumor Society (MSTS) after 12-24 months follow-ups were 24,26 and 13,respectively.And excellent functional results were obtained in short-time follow-ups.1 patient had prosthesis infection and amputation was taken after failing in conservative treatment.Unequal lengths of both lower extremities in 2 patients were less than 2 cm.Conclusion For the pediatric distal femoral osteosarcomas that has surgical indications,a new theory and therapy idea on combination of epiphysis preservation operation with custom-made prosthesis and neoadjuvant chemotherapy and standardized postoperative chemotherapy is suggested.And it has advantages of effective curative effect,easy operation,short operative time and quick recovery.However,long-term outcomes of complications should be observed further.
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A total of 35 patients with hallus valgus (56 feet) received treatment at the Department of Orthopedics, the Sixth People's Hospital, Shanghai Jiao Tong University between January 2004 and June 2005 and were recruited into this study. These patients underwent osteotomy of proximal first metatarsal and internal fixation with poly (L-lactic acid) (PLLA) absorbable pins. All patients were followed up for 4-22 months. Excellent outcomes were found in 27 patients (44 feet) and good results in 8 patients (12 feet). The mean healing time of surgical region was 6 weeks, nonunion or delayed union was not found. There were 3 cases suffering from complications post surgery. Two of them presented with peripheral wound red swelling, considering as a result of extraneous material-caused aseptic inflammatory reaction. This phenomenon would be regressed 2-4 weeks after hydropathic compress of ethanol gauzes and timely renewal of dressings. There was 1 case who suffered from protrution of absorbable pin 1 week after fixation and received reposition and plaster fixation. Bone displacement and nonunion were not found. This complication maybe results from excessively large bone pore due to shaking of electrodrill, which leads to loosening of absorbable pins.