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1.
Chinese Journal of Trauma ; (12): 481-493, 2023.
Article in Chinese | WPRIM | ID: wpr-992625

ABSTRACT

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

2.
Chinese Journal of Trauma ; (12): 309-317, 2023.
Article in Chinese | WPRIM | ID: wpr-992603

ABSTRACT

As the National Health Commission changes the management of novel corona virus infection, the situation and preventive policies for controlling the epidemic have also entered a new stage in China. Perioperative care strategies for orthopedic trauma such as designated isolation and nucleic acid test screening have also been adjusted in the new stage. Based on the perioperative work experiences in the new stage of epidemic from the frontline anti-epidemic staff of orthopedics in domestic hospitals and combined with the literature and relevant evidence-based medical data in perioperative care of orthopedic trauma patients under the current anti-epidemic policies at home and abroad, Chinese Orthopedic Association and Chinese Society of Traumatology organized relevant experts to formulate the Guideline for clinical perioperative care of orthopedic trauma patients in the new stage of novel corona virus infection ( version 2023). The guideline summarized 16 recommendations from the aspects of preoperative diagnosis and treatment, infection prevention, emergency operation and postoperative management to systematically standardize the perioperative clinical pathways, diagnosis and treatment processes of orthopedic trauma in the new stage of novel corona virus infection, so as to provide a guidance and reference for hospitals at all levels to carry out relevant work in current epidemic control policies.

3.
Chinese Journal of Applied Clinical Pediatrics ; (24): 275-280, 2023.
Article in Chinese | WPRIM | ID: wpr-990025

ABSTRACT

Objective:To investigate the clinical features of pertussis in children and analyze the risk factors of severe pertussis.Methods:The clinical data of 248 children with pertussis hospitalized in Hunan Children′s Hospital from March 2018 to March 2022 were analyzed retrospectively.According to the age at admission, the patients were divided into two groups: ≤3 months and > 3 months.According to the patient′s condition, they were classified into ordinary group and severe group.According to the pathogens detected, the children were divided into single infection group and mixed infection group.The independent sample t-test, chi- square test were used to analyze the clinical indexes of the infants in above groups. Results:(1)Of 248 hospitalized children with pertussis, 204 cases (82.2%) were less than 1 year old, 92 cases (37.0%) had contact with a coughing family member before, and 169 cases (68.1%) were unvaccinated.Among 248 children, 193 cases (77.8%) had an elevated white blood cell count, and 145 cases (58.4%) had mixed infections.The most common pathogen was respiratory syncytial virus [29/248(11.6%)]. About 173 cases (69.7%) had concurrent pneumonia, and 35 cases (14.1%) had pulmonary consolidation.(2)Compared with the group > 3 months of age, more patients in the group ≤3 months of age had contact with a coughing family member before, and suffered from cyanosis, dyspnea, respiratory failure, heart failure and pertussis encephalopathy ( χ2=4.612, 20.810, 7.882, 16.617, 13.740, 7.846, all P<0.05). The proportions of patients in the group ≤3 months of age required intensive care unit(ICU) hospitalization and mechanical ventilation were higher than those in the group > 3 months of age ( χ2=14.810, 21.436, all P<0.05). The mortality of the group ≤3 months of age was higher than that of the group >3 months of age ( χ2=12.016, P<0.05). Children ≤3 months of age had a higher WBC level [(27.83±27.70)×10 9/L vs.(23.34±15.28)×10 9/L, t=22.244, P<0.001], longer duration of spasmodic cough [(16.56±9.33) d vs.(15.06±6.16) d, t=10.145, P=0.002] and longer hospitalization time [(11.47±10.48) d vs.(9.48±4.80) d, t=20.050, P<0.001] than those >3 months of age.(3)Compared with the ordinary group, a higher proportion of children in the severe pertussis group were under 3 months old, and had not been vaccinated against pertussis vaccine ( χ2=14.803, 4.475, all P<0.05). The ratio of patients with dyspnea, an lymphocyte count/neutral cell(LC/NC) ratio <1, mixed infections, lung consolidation and pleural effusion in the severe pertussis group was higher than that in the ordinary group ( χ2=116.940, 43.625, 13.253, 106.370, 11.874, all P<0.05). The patients in the severe pertussis group had a higher WBC [(61.66±29.63)×10 9/L vs.(18.83±10.00)×10 9/L, t=112.580, P<0.001] and a lower LC (0.494±0.186 vs.0.676±0.132, t=13.752, P<0.001) than those in the ordinary group.(4)Compared with the single infection group, the proportions of children with fever, dyspnea, fine moist lung rales, an LC/NC ratio <1, and lung consolidation were higher in the mixed infection group ( χ2=8.909, 6.804, 7.563, 8.420, 12.458, all P<0.05). More children in the mixed infection group required ICU hospitalization and mechanical ventilation than those in the single infection group ( χ2=11.677, 7.397, all P<0.05). The mixed infection group had higher respiratory failure and death rates than the single infection group ( χ2=7.980, 4.267, all P<0.05). Compared with the single infection group, the mixed infection group had a higher WBC level [(27.73±24.13)×10 9/L vs.(21.25±14.65)×10 9/L, t=13.318, P<0.001], longer hospitalization time [(11.593±9.010) d vs.(8.339±4.047) d, t=17.283, P<0.001], and a smaller LC ratio (0.626±0.165 vs.0.684±0.132, t=7.997, P=0.005). (5) Logistic regression analysis showed that age ≤3 months, peak WBC and dyspnea were risk factors of severe pertussis. Conclusions:Hospitalized pertussis children are prone to pneumonia and pulmonary consolidation.Patients aged ≤3 months with a large WBC and dyspnea easily develop into severe pertussis.Monitoring blood routine is helpful for judging the severity of the disease.Mixed infections increase the incidence of complications and can impair the treatment effect.

4.
China Journal of Chinese Materia Medica ; (24): 2679-2698, 2023.
Article in Chinese | WPRIM | ID: wpr-981372

ABSTRACT

Cytisine derivatives are a group of alkaloids containing the structural core of cytisine, which are mainly distributed in Fabaceae plants with a wide range of pharmacological activities, such as resisting inflammation, tumors, and viruses, and affecting the central nervous system. At present, a total of 193 natural cytisine and its derivatives have been reported, all of which are derived from L-lysine. In this study, natural cytisine derivatives were classified into eight types, namely cytisine type, sparteine type, albine type, angustifoline type, camoensidine type, cytisine-like type, tsukushinamine type, and lupanacosmine type. This study reviewed the research progress on the structures, plant sources, biosynthesis, and pharmacological activities of alkaloids of various types.


Subject(s)
Alkaloids/chemistry , Quinolizines/pharmacology , Azocines/chemistry , Fabaceae
5.
Chinese Journal of Orthopaedics ; (12): 1660-1668, 2022.
Article in Chinese | WPRIM | ID: wpr-993401

ABSTRACT

The life safety and quality of life of elderly patients with hip fractures face great threat due to the particularity of fracture site. Elderly patients with hip fracture are often complicated with a variety of basic medical diseases, thus the perioperative management and comprehensive treatment are relatively complex and diverse, and surgical treatment is only one of the links. With the deepening understanding of senile hip fractures, we increasingly realized that the comprehensive management of senile hip fractures should focus on prevention. Combined with the conception and connotation of tertiary-prevention in preventive medicine, this review summarize the common etiology and preventive measures of senile hip fractures, the application of intelligent devices for fall prevention and monitoring, the green channel for hip fracture patient admission, the management mode of the comprehensive geriatric ward based on multi-disciplinary team, the evolution of surgical methods, and the perioperative comprehensive treatments, which in order to provide reference for medical and health workers to reduce the incidence and improve the treatment effects and prognosis of the senile hip fracture via multifaceted and systematic prevention and treatment measures.

6.
Chinese Journal of Trauma ; (12): 23-31, 2022.
Article in Chinese | WPRIM | ID: wpr-932206

ABSTRACT

Lower extremity deep vein thrombosis (DVT) is one of the main complications in patients with traumatic fractures, and for severe patients, the DVT can even affect arterial blood supply, resulting in insufficient limb blood supply. If the thrombus breaks off, pulmonary embolism may occur, with a high mortality. The treatment and rehabilitation strategies of thrombosis in patients with lower extremity fractures have its particularity. DVT in traumatic fractures patients has attracted extensive attention and been largely studied, and the measures for prevention and treatment of DVT are constantly developing. In recent years, a series of thrombosis prevention and treatment guidelines have been updated at home and abroad, but there are still many doubts about the prevention and treatment of DVT in patients with different traumatic fractures. Accordingly, on the basis of summarizing the latest evidence-based medical evidence at home and abroad and the clinical experience of the majority of experts, the authors summarize the clinical treatment and prevention protocols for DVT in patients with traumatic fractures, and make this consensus on the examination and assessment, treatment, prevention and preventive measures for DVT in patients with different fractures so as to provide a practicable approach suitable for China ′s national conditions and improve the prognosis and the life quality of patients.

7.
China Journal of Chinese Materia Medica ; (24): 281-289, 2021.
Article in Chinese | WPRIM | ID: wpr-878972

ABSTRACT

In this study, 24 copies of samples of Chrysanthemum morifolium and soil from two main production towns in Macheng city were collected, and the contents of 13 mineral elements, 5 effective components and 14 soil nutrient factors in Ch. morifolium were determined. The enrichment characteristics of available soil nutrients by mineral elements were analyzed and the dominant factors affecting the effective components of Ch. morifolium were screened. The results showed that the content of mineral elements and soil nutrients and effective components are very different, and variation of soil fertility was much greater than that of inorganic elements in chrysanthemum plants. In general, the level of element content in Ch. morifolium from different producing areas is K>N>P>Mg>Ca>Fe>Mn>Zn>Cu>Ni>Cr>Pb>Cd. The content of K, N and Mg is higher than that of common crops, and the content of Cu, Cd and Pb in Ch. morifolium from various producing areas does not exceed the relevant standards. The N, P and K enrichment capacity in soil was stronger than that of other elements, and the Ca enrichment ability was the worst. The content of AvCu in the soil was positively correlated with the contents of N, Mg, K, Fe and Cu elements in Ch. morifolium. The contents of chlorogenic acid, luteolin, 3,5-O-dicaffeoylquinic acid reached the pharmacopoeia standard. The percentage of chlorogenic acid and 3,5-O-dicaffeoylquinic acid in Ch. morifolium that from Huangtugang town in the active components were generally higher than that from Futianhe town, and the diffe-rences of luteolin contents in the two producing areas were relatively small. The correlation and regression analysis showed that the contents of Cu, Zn and Cr in Ch. morifolium were positively correlated with the active components, while the contents of Fe, Mn and Ni were negatively correlated with the contents of AvP, AvK, TK, AvMn and AvCu in soil. In general, Zn and Ca fertilizer should be added to the ecological planting of Ch. morifolium, K fertilizer should be added, and N and P fertilizer should be applied appropriately.


Subject(s)
Chrysanthemum , Fertilizers , Minerals , Nutrients , Soil
8.
Journal of Forensic Medicine ; (6): 832-835, 2021.
Article in English | WPRIM | ID: wpr-984082

ABSTRACT

OBJECTIVES@#To analyze the characteristics of sudden death associated with sexual activity to provide recommendations for forensic identification.@*METHODS@#A retrospective analysis was conducted on autopsy cases accepted by Forensic Identification Center of Huazhong University of Science and Technology from 1998 to 2018, and a total of 15 cases of sudden death associated with sexual activity were screened out. The general information, case data and pathological changes of 15 cases were collected to find the relationship between sexual activity and sudden death.@*RESULTS@#The ratio of male to female was 1.5∶1. The average age of males was 50.1 years and that of females was 35.0 years. Coronary artery diseases and brain diseases accounted for most of the cases (12/15). Sexual partners were associated with locations of deaths and body dumping behaviors.@*CONCLUSIONS@#Sudden death associated with sexual activity, although rare, may occur in people over 30 years old with pre-existing heart or brain diseases, which should be paid attention to in forensic practice.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Cause of Death , Death, Sudden/pathology , Forensic Medicine , Retrospective Studies , Sexual Behavior
9.
Chinese Journal of Orthopaedic Trauma ; (12): 911-915, 2021.
Article in Chinese | WPRIM | ID: wpr-910062

ABSTRACT

Objective:To evaluate the application of ERAS concept in the treatment of tibial plateau fractures with minimally invasive double reverse tractions (MIDRT).Methods:A retrospective study was conducted of the 39 patients with tibial plateau fracture who had been treated at Department of Orthopedics, Union Hospital from February 2018 to June 2020. They were 20 males and 19 females, aged from 27 to 47 years. All cases were treated with the same MIDRT but with different perioperative management protocols. Of them, 20 received conventional perioperative management (control group) and 19 perioperative ERAS management (ERAS group). The 2 groups was compared in terms of visual analogue scale (VAS) at 24 hours postoperation, drainage volume, time for removal of drainage tube, hospital stay, patient’s satisfaction, incidence of complications, and American Special Surgery Hospital (HSS) scores at discharge and 1, 3, 6 and 9 months postoperation.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability between groups ( P>0.05). All cases obtained complete follow-up (mean, 10.9 months). No statistically significant difference was found between the 2 groups in drainage volume, time for removal of drainage tube or HSS scores at discharge or one month after discharge ( P>0.05). The VAS score at 24 hours after operation, hospital stay [(9.4±4.8) d], patient's satisfaction, HSS scores [(90.8±3.8), (93.5±4.3) and (95.6±3.7)] in the ERAS group were significantly better than those in the control group [(13.3±1.9) d, (87.5±5.1), (88.1±4.4) and (88.8±4.4)] ( P<0.05). None of the patients had such serious complications as wound infection, breakage or failure of internal fixation, or fracture nonunion. Conclusion:The perioperative management protocols designed according to the ERAS concept may enhance the clinical efficacy of MIDRT in the treatment of tibial plateau fractures and thus raise the patient’s satisfaction.

10.
Chinese Journal of Medical Education Research ; (12): 54-58, 2021.
Article in Chinese | WPRIM | ID: wpr-883546

ABSTRACT

Objective:To investigate the application effects of SBAR communication mode (situation, background, assessment and recommendation) combined with 3D printing model technology in bed-side teaching of trauma orthopaedics.Methods:A total of 80 clinical medicine students were randomly divided into two groups according to the order of the school number, with 40 students in each group. One was experimental group which received SBAR communication mode combined with 3D printing model technology teaching, and the other one was the control group, which received regular reaching mode. At the end of teaching, the teaching effects were evaluated, including the scores of theoretical examinations and operational examinations, total scores and the anonymous questionnaires. SPSS 22.0 was used for recording and statistical analysis.Results:The average scores of theoretical examinations (48.30±1.41), operational examinations (42.20±1.48) and total scores (90.70±1.38) of experimental group were significantly higher than those of control group [(43.40±1.52); (34.80±1.53); (78.10±1.51)], with significant differences ( P <0.05). The anonymous questionnaires showed that the students in the experimental group had a significant advantage in autonomous learning ability, learning enthusiasm, the ability of literature retrieval and analysis and clinical thinking ability, and enhancing students' humanistic care consciousness in clinical work ( P <0.05). While the two groups had the same recognition in improving problem solving ability, teamwork ability and communication ability with patients, with no significant difference ( P > 0.05). Conclusion:The new teaching mode, SBAR mode combined with 3D printing model technology, applied to trauma orthopaedics bed-side teaching is helpful for students to improve their learning interest and autonomous learning ability, cultivate their lifelong learning habits and their comprehensive quality, so this mode will significantly improve the teaching effects, with good application value.

11.
Chinese Journal of Trauma ; (12): 124-128, 2020.
Article in Chinese | WPRIM | ID: wpr-811518

ABSTRACT

With the outbreak of novel coronavirus pneumonia (NCP) induced by 2019 novel coronavirus (2019-nCoV) in Wuhan, Hubei Province in December 2019, more and more suspected or confirmed cases have been found in various regions of China. Although China has adopted unprecedented strict quarantine and closed management measures to prevent the spreading of the disease, Department of Traumatic Orthopedics may still have to manage NCP patients with open fractures or severe trauma that require emergency surgery. Therefore, the identification and management of 2019-nCoV infection as soon as possible as well as the protection of all medical staff involved in the emergency treatment of patients are the severe challenges faced by orthopedic traumatologists during the prevention and control of NCP. Based on the characteristics of such patients and related diagnosis and treatment experiences during the epidemic of NCP, the authors formulate the surgical management strategies for orthopedic trauma patients.

12.
Chinese Journal of Trauma ; (12): 111-116, 2020.
Article in Chinese | WPRIM | ID: wpr-811516

ABSTRACT

Since December 2019, novel coronavirus pneumonia (NCP) has been reported in Wuhan, Hubei Province, and spreads rapidly to all through Hubei Province and even to the whole country. The virus is 2019 novel coronavirus (2019-nCoV), never been seen previously in human, but all the population is generally susceptible. The virus spreads through many ways and is highly infectious, which brings great difficulties to the prevention and control of NCP. Based on the needs of orthopedic trauma patients for emergency surgery and review of the latest NCP diagnosis and treatment strategy and the latest principles and principles of evidence-based medicine in traumatic orthopedics, the authors put forward this expert consensus to systematically standardize the clinical pathway and protective measures of emergency surgery for orthopedic trauma patients during prevention and control of NCP and provide reference for the emergency surgical treatment of orthopedic trauma patients in hospitals at all levels.

13.
Chinese Journal of Dermatology ; (12): 715-717, 2020.
Article in Chinese | WPRIM | ID: wpr-870357

ABSTRACT

Objective:To analyze clinical features of 78 infants with scabies and their causes of misdiagnosis.Methods:A retrospective analysis was performed on infants aged < 6 months with confirmed scabies at Department of Dermatology in Zhengzhou Children′s Hospital, Jingjiang People′s Hospital, Tangdu Hospital of the Fourth Military Medical University, Second Affiliated Hospital of Soochow University and Henan Provincial People′s Hospital from January 1, 2016 to December 31, 2018. Then, epidemiological features, skin lesion characteristics, treatment and causes of misdiagnosis of infantile scabies were analyzed.Results:A total of 78 infants with scabies were collected. Their age of onset and duration from onset to diagnosis [ M ( P25, P75) ] were 8.5 (7, 12) and 4 (3.5, 5) weeks respectively. At the time of diagnosis, 45 (57.7%) patients showed lower body weight than the first quartile [ P25] of body weight of age- and gender-matched healthy peers, 40 (47.4%) had fussiness and irritation, and 68 (87.2%) had sleep disorders like night crying and increased frequency of night waking. Infantile scabies more frequently occurred in autumn (30 cases [38.5%]) and winter (22 cases [28.2%]) , and least frequently occurred in summer (8 cases [10.3%]) . In the case of 58 patients, there was at least 1 member with scabies at the same time, who had resided with the patients in their families for a long time; in the case of 12 patients, scabies was transmitted through previous contact with temporary residents with scabies in their families. Scabies lesions most commonly occurred on the chest and abdominal regions (80.8%) , followed by the limbs (76.9%) ; skin lesions were polymorphic, and lesions at different stages could coexist; the rashes mainly manifested as edematous red or non-edematous brown papules, blisters, papulovesicles and nodules, and some burrows could be characterized by an oval, linear, serpiginous, comma- or J-shaped appearance. All the patients had visited the clinic for 1 - 4 times with an average of 2.38 visits. Forty-eight (61.5%) patients initially visited non-dermatology departments, and 30 (38.5%) initially visited dermatological outpatient clinics. Incorrect diagnoses included infantile eczema, papular urticaria, impetigo, miliaria, prurigo, urticaria pigmentosa, infantile acropustulosis, herpes simplex and varicella. All the patients received topical sulfur 5% ointment. Nine (11.5%) patients experienced a sudden exacerbation of skin lesions after the topical treatment, and 20 (25.6%) needed 2 - 3 sessions of treatment. No recurrence was observed in all the patients at 2, 4 and 8 weeks after the end of treatment. Conclusions:Infantile scabies lesions are polymorphic, widely distributed, and easily misdiagnosed. To prevent misdiagnosis and improve the early diagnosis rate, a detailed clinical interrogation with clinical-epidemiological examination should be performed.

14.
Chinese Acupuncture & Moxibustion ; (12): 1259-1262, 2020.
Article in Chinese | WPRIM | ID: wpr-877596

ABSTRACT

OBJECTIVE@#To analyze the rules of acupoint selection in the acupuncture treatment of cervical spondylotic radiculopathy by data mining.@*METHODS@#The randomized controlled trials (RCTs) regarding acupuncture for cervical spondylotic radiculopathy published from July 15 of 2009 to July 15 of 2019 were retrieved from databases of CNKI, VIP, Wanfang, SinoMed, PubMed and EMbase. A database was established with Microsoft Excel 2016. The frequency and total effective rate of high-frequency acupoints, meridians and acupoint combinations were analyzed, and the association rules of acupoints and meridians were analyzed by Apriori algorithm.@*RESULTS@#A total of 87 RCTs were included, involving 104 acupoints with a total frequency of 921. Among them, the high-frequency acupoints were cervical Jiaji (EX-B 2, 87 times), Fengchi (GB 20, 70 times), Houxi (SI 3, 54 times), etc. The frequently-used acupoints were mainly distributed in the hand @*CONCLUSION@#It is feasible to explore the acupoint selection and compatibility rules of acupuncture for cervical spondylotic radiculopathy by data mining. This study could provide corresponding reference for clinical treatment.


Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Data Mining , Meridians , Radiculopathy/therapy
15.
Chinese journal of integrative medicine ; (12): 694-700, 2020.
Article in English | WPRIM | ID: wpr-827090

ABSTRACT

OBJECTIVES@#To investigate the effect on essential hypertension of the topical application of TAT-Cu, Zn-superoxide dismutase (TAT-SOD) at left acupoint Zusanli (ST 36), and to observe whether the change of electrical potential difference (EPD) can be related to the change of blood pressure.@*METHODS@#Sixteen patients with essential hypertension and 16 healthy subjects were included in the study. EPD between the left acupoints of Yanglingquan (GB 34) and Qiuxu (GB 40) was firstly screened out for the EPD detection. An intracellular superoxide quenching enzyme, TAT-SOD, was topically applied to the acupoint ST 36 within an area of 1 cm once a day, and the influence on EPD was investigated. The dosage applied to TAT-SOD group (n=8) was 0.2 mL of 3000 U/mL TAT-SOD cream prepared by adding purified TAT-SOD to a vehicle cream, while placebo group (n=8) used the vehicle cream instead. The left acupoints of Yanglingquan (GB 34) and Qiuxu (GB 40) were selected for EPD measurement after comparing EPD readings between 5 acupoints on each of all 12 meridians.@*RESULTS@#EPDs between the left acupoints of GB 34 and GB 40 for 16 patients of essential hypertension and 16 healthy subjects were 44.9±6.4 and 5.6±0.9 mV, respectively. Daily application of TAT-SOD for 15 days at ST 36 of essential hypertension patients significantly decreased systolic blood pressure (SBP) and diastolic blood pressure (DBP) of 179.6 and 81.5 mm Hg to 153.1 and 74.1 mm Hg, respectively. Responding to the change in blood pressure, EPD between the left acupoints of GB 34 and GB 40 also declined from 44.4 to 22.8 mV with the same trend. No change was observed with SBP, DBP and EPD between the left acupoints of GB 34 and GB 40 with the daily application of the placebo cream.@*CONCLUSION@#Enzymatic scavenging of the intracellular superoxide at ST 36 proved to be effective in decreasing SBP and DBP. The results reconfirm the involvement of superoxide anions and its transportation along the meridians, and demonstrate that EPD between acupoints may be an indicator to reflect its functioning status. Moreover, preliminary results suggest a close correlation between EPD and blood pressure readings, implying a possibility of using EPD as a sensitive parameter for blood pressure and to monitor the effect of antihypertensive treatment.

16.
Chinese Journal of Trauma ; (12): 24-30, 2020.
Article in Chinese | WPRIM | ID: wpr-798617

ABSTRACT

Objective@#To explore the clinical effect of bone grafting in the injured vertebrae combined with pedicle screw-rod system assisted with drugs in treating lumbar vertebral compression fracture in the elderly.@*Methods@#A retrospective case-control study was carried out to analyze the clinical data of 48 cases of lumbar vertebral compression fracture in the elderly admitted to the Union Hospital between October 2015 and October 2018. There were 34 males and 14 females, aged 60-78 years [(62.8±2.5)years]. Segment of injury was L1 in 37 cases, L2 in 7, L3 in 2, and L4 in 4. There were 20 cases in bone grafting group involving 15 males and five females, aged from 60 to 78 years [(63.7±2.1)years]. There were 28 cases in non-bone grafting group involving 19 males and nine females, aged from 60 to 75 years [(62.4±2.9)years]. The Frankel scale in bone grafting group was grade D in 15 cases and grade E in 5, and in non-bone grafting group was grade D in 18 cases and grade E in 10. All the cases were treated by pedicle screw fixation combined with antiosteoporosis drugs, and the bone grafting group were treated by bone grafting via the injured vertebrae, but the other group were not. The intraoperative blood loss and operation time for each segmental vertebrae were recorded. The visual analogue scale (VAS) before operation and one year after operation, the bone healing at three months and one year postoperatively were recorded. The compression rate of the injured vertebrae at operation, at one day and one-year postoperatively as well as the height loss of the injured vertebrae at postoperative one year were measured. Spinal cord injury was also evaluated by Frankel scale. Wound healing, lower limb thrombosis, lung infection and ulcer were observed.@*Results@#All the cases were followed up, with duration for 12-25 months [(16.2±3.4)months] in bone grafting group and 15-24 months [(17.5±5.4)months] in non-bone grafting group (P>0.05). The blood loss was (240±70)ml in bone grafting group and (210±65)ml in non-bone grafting group (P>0.05). Screw implantation time for each segment was (38.5±9.6)minutes in bone grafting group and (30.5±5.4)minutes in non-bone grafting group (P<0.05). The VAS was (7.5±1.8)points preoperatively and (1.5±0.7)points at one year postoperatively in bone grafting group, while (7.8±1.4)points and (2.9±1.2)points in non-bone grafting group, with significant difference between the two groups at one year postoperatively (P<0.05). The fracture healing rate was 85% (17/20) and 95% (19/20) at three months and one year postoperatively in bone grafting group, while 64%(18/28) and 86%(24/28) in non-bone grafting group, with no statistical difference between the two groups (P>0.05). No significant difference was found in compression rate of the injured vertebral height between the two groups before and after operation (P>0.05). The height loss rate of the injured vertebrae was 3% (2%, 4%) at one year postoperatively in bone grafting group and 6% (5%, 8%) in non-bone grafting group (P<0.05). The Frankel scale was all Grade E postoperatively. During the follow-up, no lower limb thrombosis, lung infection or ulcer occurred. One case had bone non-union in bone grafting group and four in non-bone grafting group (P>0.05).@*Conclusion@#For lumbar vertebral compression fracture in the elderly, bone grafting in the injured vertebrae combined with pedicle screw-rod system assisted with drugs is significantly better in recovering and maintaining the injured vertebrae height, relieving the pain and promoting the bone healing, although the screw implantation time is prolonged.

17.
Chinese Journal of Trauma ; (12): 111-116, 2020.
Article in Chinese | WPRIM | ID: wpr-867685

ABSTRACT

Since December 2019, corona virus disease 2019 (COVID-19) has been reported in Wuhan, Hubei Province, and spreads rapidly to all through Hubei Province and even to the whole country. The virus is 2019 novel coronavirus (2019-nCoV), never been seen previously in human, but all the population is generally susceptible. The virus spreads through many ways and is highly infectious, which brings great difficulties to the prevention and control of COVID-19. Based on the needs of emergency surgery for orthopedic trauma patients and review of the latest diagnosis and treatment strategy of COVID-19 and the latest principles and principles of evidence-based medicine in traumatic orthopedics, the authors put forward this expert consensus to systematically standardize the clinical pathway and protective measures of emergency surgery for orthopedic trauma patients during prevention and control of COVID-19 and provide reference for the emergency surgical treatment of orthopedic trauma patients in hospitals at all levels.

18.
Chinese Journal of Trauma ; (12): 124-128, 2020.
Article in Chinese | WPRIM | ID: wpr-867683

ABSTRACT

With the outbreak of corona virus disease 2019 (COVID-19) caused by 2019 novel coronavirus (2019-nCoV) in Wuhan, Hubei Province in December 2019, more and more suspected or confirmed patients have been found in various regions of China. Although China has adopted unprecedented strict quarantine and closed management measures to prevent the spreading of the disease, Department of Traumatic Orthopedics may still have to manage COVID-19 patients with open fractures or severe trauma that require emergency surgery. Therefore, the identification and management of 2019-nCoV infection as soon as possible as well as the protection of all medical staff involved in the emergency treatment of patients are the serious challenges faced by orthopedic traumatologists during the prevention and control of COVID-19. Based on the characteristics of such patients and related diagnosis and treatment experiences during the epidemic of COVID-19, the authors formulate the strategies of surgical management and infection prevention and control for orthopedic trauma patients.

19.
Chinese Journal of Trauma ; (12): 24-30, 2020.
Article in Chinese | WPRIM | ID: wpr-867666

ABSTRACT

Objective To explore the clinical effect of bone grafting in the injured vertebrae combined with pedicle screw-rod system assisted with drugs in treating lumbar vertebral compression fracture in the elderly.Methods A retrospective case-control study was carried out to analyze the clinical data of 48 cases of lumbar vertebral compression fracture in the elderly admitted to the Union Hospital between October 2015 and October 2018.There were 34 males and 14 females,aged 60-78 years [(62.8 ± 2.5) years].Segment of injury was L1 in 37 cases,L2 in 7,L3 in 2,and L4 in 4.There were 20 cases in bone grafting group involving 15 males and five females,aged from 60 to 78 years [(63.7 ± 2.1)years].There were 28 cases in non-bone grafting group involving 19 males and nine females,aged from 60 to 75 years [(62.4 ± 2.9) years].The Frankel scale in bone grafting group was grade D in 15 cases and grade E in 5,and in non-bone grafting group was grade D in 18 cases and grade E in 10.All the cases were treated by pedicle screw fixation combined with antiosteoporosis drugs,and the bone grafting group were treated by bone grafting via the injured vertebrae,but the other group were not.The intraoperative blood loss and operation time for each segmental vertebrae were recorded.The visual analogue scale (VAS) before operation and one year after operation,the bone healing at three months and one year postoperatively were recorded.The compression rate of the injured vertebrae at operation,at one day and one-year postoperatively as well as the height loss of the injured vertebrae at postoperative one year were measured.Spinal cord injury was also evaluated by Frankel scale.Wound healing,lower limb thrombosis,lung infection and ulcer were observed.Results All the cases were followed up,with duration for 12-25 months [(16.2 ±3.4) months] in bone grafting group and 15-24 months [(17.5 ± 5.4) months] in non-bone grafting group (P > 0.05).The blood loss was (240 ± 70) ml in bone grafting group and (210 ± 65) ml in non-bone grafting group (P > 0.05).Screw implantation time for each segment was (38.5 ±9.6)minutes in bone grafting group and (30.5 ±5.4)minutes in non-bone grafting group (P < 0.05).The VAS was (7.5 ± 1.8)points preoperatively and (1.5 ± 0.7)points at one year postoperatively in bone grafting group,while (7.8 ± 1.4) points and (2.9 ± 1.2) points in non-bone grafting group,with significant difference between the two groups at one year postoperatively (P < 0.05).The fracture healing rate was 85% (17/20) and 95% (19/20) at three months and one year postoperatively in bone grafting group,while 64% (18/28) and 86% (24/28) in non-bone grafting group,with no statistical difference between the two groups (P > 0.05).No significant difference was found in compression rate of the injured vertebral height between the two groups before and after operation (P > 0.05).The height loss rate of the injured vertebrae was 3% (2%,4%) at one year postoperatively in bone grafting group and 6% (5%,8%) in non-bone grafting group (P <0.05).The Frankel scale was all Grade E postoperatively.During the follow-up,no lower limb thrombosis,lung infection or ulcer occurred.One case had bone non-union in bone grafting group and four in non-bone grafting group (P > 0.05).Conclusion For lumbar vertebral compression fracture in the elderly,bone grafting in the injured vertebrae combined with pedicle screw-rod system assisted with drugs is significantly better in recovering and maintaining the injured vertebrae height,relieving the pain and promoting the bone healing,although the screw implantation time is prolonged.

20.
Chinese Journal of Medical Genetics ; (6): 445-448, 2020.
Article in Chinese | WPRIM | ID: wpr-826559

ABSTRACT

OBJECTIVE@#To carry out genetic testing and prenatal diagnosis for a family affected with recessive dystrophic epidermolysis bullosa (RDEB).@*METHODS@#All exons of the COL7A1 gene and their flanking regions were subjected to PCR and Sanger sequencing. Suspected variant was validated in family members, based on which prenatal diagnosis was provided.@*RESULTS@#Sanger sequencing found that the proband has carried two variants of the COL7A1 gene, namely c.7289delC (p.Pro2430Glnfs*36) and c.7474C>T (p.Arg2492*), which were respectively derived from his mother and father. The same variants were not found among 100 healthy controls. By prenatal diagnosis, the fetus was found to have inherited the c.7474C>T (p.Arg2492*) variant from its father.@*CONCLUSION@#The pathogenic variants of the COL7A1 gene of the RDEB family were clarified, based on which prenatal diagnosis was provided.


Subject(s)
Child , Female , Humans , Male , Pregnancy , Collagen Type VII , Genetics , Epidermolysis Bullosa Dystrophica , Genetics , Exons , Genes, Recessive , Genetic Testing , Mutation , Prenatal Diagnosis , Sequence Analysis, DNA
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