Application research of PBL teaching based on POA theory in clinical practice teaching in the department of hand and foot surgery / 中华医学教育探索杂志

Objective:To explore the application value of problem-based learning (PBL) based on production-oriented approach (POA) theory in clinical practice teaching in department of hand and foot surgery.Methods:A total of 112 interns from the Department of Hand and Foot Surgery in Affiliated Hospital of Jining Medical University from January 2019 to October 2020 were randomly divided into control group and observation group, with 56 interns in each group. The control group was taught by PBL teaching, and the observation group was taught by PBL teaching based on POA theory. The two groups of interns were compared in terms of the evaluation of teaching effect, the statistics of errors in practice assessment, the assessment scale of independent learning ability, the career maturity inventory attitude scale, and the satisfaction of interns with their teachers. SPSS 25.0 was used for Chi-test and t-test. Results:The teaching effect and the satisfaction of interns with the teacher in the observation group were better than those of the control group ( P<0.05); the error rate of unskilled physical examination and the error rate of poor aseptic debridement concept in the observation group were all lower ( P<0.05); there was no significant difference in the error rate of irregular writing of medical records, the error rate of lack of medical history collection, and the error rate of communication errors between the two groups ( P>0.05). After teaching, the scores of independent learning ability and career maturity inventory attitude scale in the observation group were higher than those in the control group ( P<0.05). Conclusion:The PBL teaching based on POA theory has a good effect in the clinical practice teaching in the department of hand and foot surgery, and it is worthy of further promotion.

Application of closed negative pressure drainage technique in hand and foot trauma surgery / 中国基层医药

Objective@#To explore the clinical application value of closed negative pressure drainage technique in the treatment of external foot injury.@*Methods@#Sixty-eight patients with hand and foot trauma admitted to the Enze Hospital of Taizhou Enze Medical Center (Group) from November 2017 to November 2018 were randomly divided into the control group and the observation group according to the digital table, with 34 cases in each group.The control group underwent routine skin grafting.The observation group underwent closed vacuum drainage.The therapeutic effects, wound healing rate and clinical observation indicators were compared between the two groups.@*Results@#The total effective rate (88.24%) and the overall wound healing rate (100.00%) in the observation group were significantly higher than those in the control group (64.71%, 79.41%) (χ2=5.231, 7.803, P=0.022, 0.005). The operation time[(5.92±1.02)h], wound healing time[(16.65±8.01)d] and hospitalization time[(31.42±13.05)d] in the observation group were significantly shorter than those in the control group[(8.33±1.65)h, (23.51±12.12)d, (46.35±18.89)d](t=7.244, 2.753, 3.792, P=0.001, 0.008, 0.001).@*Conclusion@#Application of closed negative pressure drainage technique in hand and foot trauma surgery can effectively improve clinical efficacy, accelerate the healing speed of wounds, and reduce the operation time and hospitalization time of patients.It is worthy of promotion.

Características clínico epidemiológicas de pacientes pediátricos con enfermedad boca, mano, pie / Clinical epidemiological characteristics of pediatric patients with mouth, hand and foot disease

Introducción: la enfermedad boca, mano, pie es una enfermedad febril eruptiva provocada por la infección por los virus Coxsackie, consistente en fiebre, exantema pápulo-vesicular en las manos, los pies y un enantema ulceroso en la boca. Objetivos: indagar la etiología viral y describir las características clínico epidemiológicas de la entidad. Métodos: estudio descriptivo prospectivo en 54 pacientes menores de 18 años, diagnosticados con la enfermedad boca, mano, pie, atendidos en el Hospital Pediátrico Docente del Cerro, de septiembre a noviembre de 2017. Se incluyeron aquellos con lesiones vesiculares o pápulas vesiculares, distribuidas en la piel y úlceras en la mucosa oral; y se excluyeron los pacientes con otras entidades exantemáticas o vesiculares. Las variables investigadas resultaron: la edad, el sexo, los signos, los síntomas clínicos de infección, el leucograma y el estudio virológico. La selección de la muestra fue de manera no probabilística consecutiva. Los datos se procesaron por el paquete estadístico XLSTAT con análisis univariado. Resultados: el grupo entre 1-3 años obtuvo 53,7 por ciento, y el sexo masculino el 68,5 por ciento. Las lesiones cutáneas fueron más frecuentes en la cara, las extremidades, los glúteos y el tronco (68,6 por ciento), seguido de la zonas de la cara, las extremidades y el tronco (29,6 por ciento). El enantema fue apreciado en el 48,1 por ciento, la fiebre en el 61,1 por ciento, la fiebre más secreción nasal en el 44,4 por ciento y el prurito en el 70,3 por ciento. El conteo leucocitario alcanzó 11,1 x 109 células. Los polimorfonucleares obtuvieron promedio de 37,9 y los linfocitos 70,3. En 49 de los 54 pacientes se aisló el virus Coxsackie A6. Conclusiones: se describe la enfermedad boca, mano, pie en forma atípica, cuyo cuadro clínico coincide con lo aparecido en la literatura(AU)

Introduction: mouth, hand and foot disease is an eruptive febrile illness caused by the infection of Coxsackie viruses, and it consists in fever, papulo-vesicular exanthema in the hands, feet and an ulcer enanthema in the mouth. Objectives: to investigate the viral etiology and describe the clinical epidemiological characteristics of the entity. Methods: prospective descriptive study in 54 patients under 18 years old diagnosed with mouth, hand and foot disease, and whom were attended at the Pediatric Teaching Hospital of Cerro from September to November 2017. Those with vesicular lesions or vesicular papules distributed in the skin, and ulcers in the oral mucosa were included in the research; and patients with other exanthematic or vesicular entities were excluded. The variables investigated were: age, sex, signs, clinical symptoms of infection, leukogram and virological study. The selection of the sample was consecutive non-probabilistic. The data was processed by the XLSTAT statistical package with univariate analysis. Results: the group from 1 to 3 years old represented the 53.7 percent, and the male sex the 68.5 percent y. Skin lesions were more frequent on the face, extremities, buttocks and trunk (68.6 percent), followed by facial, limbs and trunk areas (29.6 percent). Enanthem was visible in 48.1 percent, and fever appeared in 61.1 percent, fever plus nasal discharge in 44.4 percent and itching in 70.3 percent y The leukocyte count reached 11.1 x 109 cells. Polymorphonuclear cells obtained an average of 37.9 and lymphocytes of 70.3. In 49 of the 54 patients the Coxsackie A6 virus was isolated. Conclusions: mouth, hand, and foot disease is described in an atypical form, whose clinical manifestations coincide with what appeared in the literature(AU)

Acupoint selection for acupuncture analgesia based on the relationship of "the opening-closing- pivoting theory" with meridians and organs / 中国针灸

"The opening-closing-pivoting theory" recorded in () visualizes the activity of six meridians and indicates the relationship among the six meridians in physiology and pathology. Through the analysis on the classic medical works and modern literature of TCM by the modern medical masters, a specific relationship is discovered among the hand and foot meridians of the same name and among the organs. The is corresponded and interacted among the hand and foot meridians of the same name. Except the exterior and interior relationship among the organs, the related communication is also existing. Both meridians and organs are closely related to "the opening-closing- pivoting" theory. This discovery is the inheritance and development of "the opening-closing-pivoting theory" and plays the important role in the guidance of the acupoint selection of clinical acupuncture analgesia.

Estimation of Stature from Hand and Foot Dimensions of Annang Indigene of Akwa Ibom State, Nigeria.

Background: Stature is a significant anthropometric determinant of the physical identity of an individual. Aim: This study was carried out to estimate stature of Nigerian Annang indigenes of Akwa Ibom State from hand and foot dimensions. Methods: Two hundred (200) adults Annang indigenes (100 male and female each) were randomly selected for this study. Hand and foot dimensions were obtained by direct linear measurements using a 150mm digital vernier caliper (with accuracy of 0.01mm); while stature was determined by stadiometric measurement of the height (to the nearest 0.1m). Measurements obtained include; second (2D), fourth digit (4D) and right foot length (RFL). All measurement were converted to centimeters (cm). SPSS (IBM® version 20, Armonk, New York, USA) t-test was to evaluate gender difference in the measured dimensions; while Pearson’s correlation and Generalized Linear Modeling were used to derive Regression equation for estimation of stature from the measured dimensions. The significance level was set at 95% as P≤0.05 was considered significant. Results: The t-test showed that males displayed significantly higher mean values than the females for all measured parameters (P<0.001). Single regression sex specific regression formulae were derived and the result showed that better prediction (r) values were obtained for females F (2D=0.428, 4D=0.430, RFL=0.587; P<0.01) population when compared to males M (2D=0.319, 4D=0.231, RFL=0.456; P<0.05). Conclusion: This study suggests the existence of sexual difference in hand and foot dimension and also the possibility of accurately estimating stature from the right foot length, right second and fourth digit.

Clinical and Radiographic Outcomes of Simple Curettage and Graft Using Allogenic Bone or Bone Substitute for Enchondroma Involving Short Tubular Bone of the Hand and Foot / 대한정형외과학회잡지

PURPOSE: We analyzed outcomes after management of enchondroma involving short tubular bones of the hand and foot by curettage and grafting using allogenic bone or bone substitutes. MATERIALS AND METHODS: Twenty-two patients (allogenic bone 15 and bone substitutes 7 patients) were recruited. Clinical results were assessed by pain, cosmetic problem, range of motion of joint and the power of grasp. Radiographic outcomes were analyzed by degree of bone defect. RESULTS: Clinically, 19 patients were classified as excellent and 3 patients as good. Three patients with K-wire fixation had pain with local irritation, which was easily controlled by removal of the K-wires. There were no complications including deep infection, delayed or nonunion, refracture. Radiographically, 20 cases were classified as group 1 (bone defect smaller than 3 mm) and the 2 remaining cases were classified as group 2 (bone defect 4-10 mm). CONCLUSION: Curettage and graft using allogenic bone or bone substitute is an effective modality of treatment for enchondroma involving short tubular bones of the hand and foot. When combined with pathologic fracture, early surgical management could shorten duration of immobilization. Surgical management might be considered for the lesion involving the foot when discovered because of high incidence of pathologic fracture.

Hand and foot syndrome secondary to capecitabine.

A 55-year-old woman on treatment with capecitabine and paclitaxel for breast carcinoma presented with history of a tingling sensation in her hands and feet with a progressive burning sensation. She also noted discomfort, minimal pain and stiffness while holding objects. On examination, there was patchy hyperpigmentation of both the palms and soles, and the dorsa of hands and feet. This was accompanied by a thickening of the skin more over the knuckles and toes. In addition there was a moist desquamation around the toes and over the palmar creases and a bluish discoloration of the lunulae of both thumbnails. She was diagnosed with hand and foot syndrome and started on pyridoxine and emollients. The finding of keratoderma noted in our patient is not seen commonly in hand and foot syndrome.

Treatment Outcomes of Advanced Stage Malignant Melanoma in Hand and Foot after Amputation in Korean Patients

BACKGROUND: A retrospective study was conducted to review the overall survival and treatment outcomes of high grade melanoma in the extremity to explore the clinical features of malignant melanoma of the hand and foot, and the therapeutic efficacies and survival rate after amputation. METHODS: The clinical data of 30 patients with malignant melanoma of the hand and foot (confirmed by pathological examination), who were admitted and treated in our hospital between 2001 and 2010, were analyzed retrospectively. We analyzed variables affecting overall and disease-free survival. RESULTS: Thirty patients (18 men and 12 women) treated with an amputation procedure for malignant melanoma in the hand or foot constituted the study cohort. The average age of the patients at the time of diagnosis was 58.7 years. Univariate analysis for overall melanoma survival revealed that diagnosis at over 70 years of age, postoperative lymph node metastasis, and location of the tumor were significant prognostic factors. And on the Kaplan-Meier survival curve, old age, American Joint Committee on Cancer stage and postoperative lymph node metastasis showed statistically significant differences in the 5-year survival rate. Also, amputation with aggressive lymph node dissection showed improved long term survival in advanced stage melanoma. CONCLUSIONS: In Korean melanoma patients, for the treatment of high grade melanomas in the extremities after amputation, early diagnosis and postoperative follow-up for evaluation of lymph node metastasis are critical factors for long-term survival. And by performing lymph node dissection during amputation, we may improve the survival rate in advanced stage melanoma patients.

Dense distribution of macrophages in flexor aspects of the hand and foot of mid-term human fetuses / 대한해부학회지

In the developing human musculoskeletal system, cell death with macrophage accumulation occurs in the thigh muscle and interdigital area. To comprehensively clarify the distribution of macrophages, we immunohistochemically examined 16 pairs of upper and lower extremities without the hip joint (left and right sides) obtained from 8 human fetuses at approximately 10-15 weeks of gestation. Rather than in muscles, CD68-positive macrophages were densely distributed in loose connective tissues of the flexor aspects of the extremities, especially in the wrist, hand and foot. In contrast, no or fewer macrophages were evident in the shoulder and the extensor aspects of the extremities. The macrophages were not concentrated at the enthesis of the tendon and ligament, but tended to be arranged along other connective tissue fibers. Deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end-labeling revealed apoptosis in the hand lumbricalis muscles, but not in the area of macrophage accumulation. Likewise, podoplanin-positive lymphatic vessels were not localized to areas of macrophage accumulation. Re-organization of the connective tissue along and around the flexor tendons of the hand and foot, such as development of the bursa or tendon sheath at 10-15 weeks, might require the phagocytotic function of macrophages, although details of the mechanism remain unknown.

Application of special life quality scale in effect evaluation of T2～4 transection of sympathetic chain to treat hyperidrosis of hand and foot / 中国实用护理杂志

Objective To evaluate the value of the specific quality of life scale in effect evaluation of T2～4 transection of sympathetic chain to treat hyperidrosis of hand and foot. Methods 125 patients with hyperidrosis of hand and foot who had accepted operation in our department were retrospectively analyzed. These patients were evaluated with the specific QOL scale. The degree of satisfaction, days of stay,time of operation and complications were also recorded. The difference of life quality score was also compared and underwent correlation analysis. Results An obvious improvement of QOL was observed after operation. The same tend could be observed in the degree of satisfaction with the operation. The operation had been proved to be safe and effective. Few serious complication were reported. The alleviation of QOL and compensatory hyperhidrosis dominated the result of degree of satisfaction. Conclusions Operation can improve quality of life of hyperhidrosis patients greatly. The specific QOL questionnaire of hyperhidrosis has a bright future in clinical practice.

Compound Indometacin Tincture Treat Eczema on Hand and Foot of 48 Cases of Children / 浙江中医药大学学报

[Objective]To explore the effective method for eczema on hand and foot of children.[Method]Apply Compound Indometacin Tincture(CIT) to 48 cases of eczema on hand and foot of children.[Result]30 cases were cured,8 cases had marked effect,5 effective,5 cases no effect,the total effective rate was 89.58%.[Conclusion]CIT has good therapeutic effect on eczema on hand and foot of children.Its effect is similar to that of steroid hormone.

The Clinical Comparison of Ganglions in Hand and Foot / 대한족부족관절학회지

PURPOSE: To compare clinical characteristics of ganglions in hand & Foot. MATERIALS AND METHODS: Seventeen cases of ganglions located in foot and fifty-five cases in hand. Excised from Mar.1988 to Apr.2003, were included in the study. The clinical characteristics and recurrence ratio were evaluated RESULTS: The mean size of 2.2 cm in hand and 2.5 cm in foot. The most common area of ganglions are dorsum of foot and wrist. The cosmetic problem of palpable mass is the primary chief complaint of ganglions on hand and the pain is that of foot. The recurrence was found in 5 cases in hand and 4 cases in foot. The recurrence was related to incomplete excision of ganglion in foot and the large size of ganglion and incomplete excision of ganglion in hand. CONCLUSION: recurrence ratio in the cases of foot is higher than that of hand. The ganglions in foot and hand need to treated by meticulous surgical excision to prevent the recurrence.

Tumoral Calcinosis at Hand and Foot: A Case Report / 대한정형외과학회잡지

In 1943, Alberto Inclan reported tumoral calcinosis in 3 cases at major joints. This condition usually showed large, painless calcified mass in major juxtaarticular sites, and evidence of familial or racial predisposition in blacks but abnormal values of serum calcium and phosphorus, association with renal disease, metabolic disorder and collagen disease are seldom seen. Tumoral calcinosis in large joints such as hip, knee, elbow and shoulder was reported several cases. Tumoral calcinosis in hand and foot is very rare and not reported yet in this country. Recently, authors experienced a case of tumoral calcinosis in both hands and right foot and cured without recurrence in 1 year follow up.