A Review of Surgically Treated Distal Radius Fractures in a University Hospital

@#Introduction: Distal radius fracture (DRF) is the most common orthopaedic injury with a reported incidence of 17.5%. It is commonly seen in young males and elderly females. Over the last two decades, there is an increasing tendency to treat DRF surgically by open reduction and internal fixation (ORIF) with plate and screws owing to improved device design, better fixation and operative technique. The purpose of this study was to evaluate the demographic characteristics, type and method of fixation, and outcome in all surgically treated DRF cases from 2014 to 2018 in a university hospital. Materials and methods: A retrospective review of all surgically treated DRF cases with one year follow-up in a tertiary hospital in Malaysia was done. Patients who left the follow-up clinic before one-year post-surgery or before fracture union were excluded. A total of 82 patients with 88 DRF were finally included into the study and outcome in terms of union time and need of multiple surgeries were analysed along with the predictors. Results: In this study, mean age of the patient was 46.2 years. Motor vehicle accident was the commonest cause of the fracture and AO Type C fracture was the commonest fracture type. Seventeen (19.3%) out of 88 fractures were compound fracture. Open reduction and internal fixation with volar plate was the most common surgical technique done in this series (93.2%). Three (3.5%) out of 88 fractures required multiple surgeries and eighty-three (94.3%) DRF cases were united before nine months of the surgery in this study. There was statistically significant association between clinical type of the fracture and the union time (p-value <0.05). Conclusion: There was a 1.7:1 male-female ratio with AOC fracture being the most common type of fracture. The most common method of fixation was ORIF with volar locked plate. Patients with closed fractures have a higher rate of union compared to open fractures at nine months.

Biochemical analysis between common type and critical type of COVID-19 and clinical value of neutrophil/lymphocyte ratio / 南方医科大学学报

OBJECTIVE@#To identify the key biochemical indicators that affect the clinical type and outcomes of COVID-19 patients and explore the application of neutrophil/lymphocyte ratio (NLR) in COVID-19.@*METHODS@#Ninety-three patients with confirmed diagnosis of COVID-19 admitted in Ezhou Central Hospital from February to April in 2020 were analyzed. Among them, 43 patients were selected from Intensive Care Unit (ICU) with the diagnosis of critical type of COVID-19, and 50 cases of common type were selected from the Department of Respiratory Medicine. The baseline data, blood routine test and biochemical indexes of the patients were collected on the first day of admission. NLRs of the patients were calculated, and COX survival analysis according to the NLR 4-category method was performed. The patients' outcomes were analyzed with receiver operating curves (ROCs). The patients were divided into two groups according to NLR cutoff value for comparison of the biochemical indexes. Based on the patients' outcomes, NLR cutoff value classification and clinical classification, multiple binary logistics regression was performed to screen the key variables and explore their significance in COVID-19.@*RESULTS@#The NLR four-category method was not applicable for prognostic evaluation of the patients. The cut-off value of NLR for predict the prognosis of COVID-19 was 11.26, with a sensitivity of 0.903 and a specificity of 0.839; the laboratory indicators of the patients with NLR < 11.26 were similar to those in patients of the common type; the indicators were also similar between patients with NLR≥11.26 and those with critical type COVID-19. NLR, WBC, NEUT, PCT, DD, BUN, TNI, BNP, and LDH had significant effects on the clinical classification and outcome of the patients ( < 0.05); Cr, Ca, PH, and Lac had greater impact on the outcome of the patients ( < 0.05), while Na, PCO had greater impact on the clinical classification of the patients ( < 0.05).@*CONCLUSIONS@#NLR can be used as an important reference for clinical classification, prognostic assessment, and biochemical abnormalities of COVID-19. Patients of critical type more frequently have bacterial infection with more serious inflammatory reactions, severer heart, lung and kidney damages, and much higher levels of DD and LDH than those of the common type. NLR, NEUT, DD, TNI, BNP, LDH, Ca, PCT, PH, and Lac have obvious influence on the prognosis of COVID-19 and should be observed dynamically.

Radiomics features of ascending and descending nasopharyngeal carcinoma / 中南大学学报(医学版)

OBJECTIVES@#To evaluate the application value of CT-based radiomics features for the ascending and descending types of nasopharyngeal carcinoma (NPC).@*METHODS@#A total of 217 NPC patients (48 ascending type and 169 descending type), who obtained CT images before radiotherapy in Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University from February 2015 to October 2017, were analyzed retrospectively. All patients were randomly divided into a training set (=153) and a test set (=64). Gross tumor volume in the nasopharynx (GTVnx) was selected as regions of interest (ROI) and was analyzed by radiomics. A total of 1 300 radiomics features were extracted via IBEX. The least absolute shrinkage and selection operator (LASSO) logistic regression was performed to choose the significant features. Support vector machine (SVM) and random forest (RF) classifiers were built and verified.@*RESULTS@#Six features were selected by the LASSO from 1 300 radiomics features. Compared with SVM classifier, RF classifier showed better classification performance. The area under curve (AUC) of the receiver operating characteristic (ROC) curve, accuracy, sensitivity, and specificity were 0.989, 0.941, 1.000, and 0.924, respectively for the training set; 0.994, 0.937, 1.000, and 0.924, respectively for the validation set.@*CONCLUSIONS@#CT-based radiomics features possess great potential in differentiating ascending and descending NPC. It provides a certain basis for accurate medical treatment of NPC, and may affect the treatment strategy of NPC in the future.

The clinical types and application of perforator branches of anterosuperior malleolus flap / 中华显微外科杂志

Objective To introduce the clinical types of perforator branches of anterosuperior malleolus flap and explore its application.Methods Anterosuperior malleolus flap coupling with dorsal pedal flap was used for repairing the soft tissue defect of hands in 18 patients,in which anterosuperior malleolus flap-dorsal pedal single flap in 12 cases,anterosuperior malleolus flap-dorsal pedal bilobate flap in 4 cases,anterosuperior malleolus flap-dorsal pedal trilobate flap in 2 cases;Anterosuperior malleolus retrograde island (bone) flap was used in recovering pedal soft tissue in 22 patients,the flap pedicled from stem of anterior tibial artery in 16 cases,dorsal pedal flap-anterosuperior malleolus flap in 2 cases,the flap from perforate vessels without injuring the anterior main tibial artery in 2 cases,the bone flap combined with the distal of tibia in 2 cases.Results In the 18 cases of hands,17 cases survived,and 1 case of flap mild necrosis at the distal site took a second-phase skin-grafting to repair.Twenty cases of anterosuperior malleolus retrograde island (bone) flap survived,and the other 2 cases needed secondary skin-grafting to repair the necrosis edge of flaps because of venous limited.After a follow-up from 3 to 6 months,30 cases showed the satisfied postoperative outlook,with the good healing of the donor sites.Typing the 40 cases according to the location of perforator branches of the anterosuperior malleolus flap,20 cases locate in the medial of anterior tibial muscle,16 cases locate between the anterior tibial muscle and extensor hallucis longus,4 cases locate between extensor hallucis longus and extensor digitorum longus.Conclusion Knowing the clinical types of the perforator branches of anterosuperior malleolus flap is not only helpful for the accurate processes of operations、preventing cutaneous branches,but also improving the success rate of surgery.

Study on correlation between viral replication and liver fibrosis indicators in patients with chronic hepatitis B in Lanzhou / 国际检验医学杂志

Objective To investigate the correlation between the liver fibrosis markers laminin(LN),hyaluronan acid(HA),col-lagen Ⅳ(CⅣ)and procollagen type Ⅲ N-terminal peptide(PⅢNP)with the replication of hepatitis B virus(HBV)DNA in the pa-tients with chronic HBV in Lanzhou.Methods Real-time PCR and chemiluminescent immunoassay(CLIA)were used to quantita-tively measure serum HBV-DNA and liver fibrosis markers in 724 cases of HBV infection in Lanzhou with the different clinical classifications and the natural history stage as the background.Results The values of the liver fibrosis indicators and HBV-DNA level in all clinical types were higher than normal levels,and reached to maximum in the liver cirrhosis goup;CⅣ and PⅢNp were highest in the HBeAg (+)CHB group;according to the hepatitis B natural history stage,the PⅢNP and CⅣ values reached the peak value in the immune clearance phase,moreover the CⅣmean value in the HBeAg and HBV-DNA (+)group was higher than that in the HBV-DNA and HBeAg (-)group.4 indicators in the HBeAg (+)CHB group were higher than those in the HBeAg (-)CHB group,but only HA had statistical difference(P <0.01 ).Conclusion There is certain correlation between CⅣ with HBV-DNA and HBV-M,indicating that which can indirectly reflect the degree of liver damage and viral replication level.

Effective guidance for clinical type postgraduates in department of neurosurgery / 中华医学教育探索杂志

This article shared opinions on how to effective educate clinical type postgraduates in department of neurosurgery based on the teaching models in the first affiliated hospital of Chongqing medical university. In the proposed training program,medical ethics education and comprehensive training including clinical thinking and practical skills training should be emphasized.Scientific inquisitiveness of the neurological research and the writing and oral communication in English should also be promoted.This training program will be fully committed to produce highly qualified,ethical and caring neurosurgeons for future needs of the society.

Problems in training of clinical type postgraduate of neurosurgery and its countermeasures / 中华医学教育探索杂志

Great difficulties and challenges are existed in the training of clinical type postgraduate of neurosurgery because of the acute onset,server illness and difficult diagnosis of neurosurgical diseases.This paper proposed countermeasures of combing theory with clinical practice and strengthening comprehensive ability after analyzing problems of inadequate professional knowledge,lack of doctor-patient communication and insufficient clinical thinking and innovating ability.The aim was to cultivate the overall quality of postgraduates,making them more qualified for the difficult task of being neurosurgery clinicians.

Types of Cerebral Palsy and Comorbidity between Premature and Full-term hildren / 中国康复理论与实践

@#Objective To discuss the differences of the types of cerebral palsy and the comorbidity between premature and full-term infants. Methods 233 children with cerebral palsy were divided into premature group (n=98) and full-term group (n=125). The types of cerebral palsy and the complications were analyzed. Results The high risk factors were low birth weight, jaundice, asphyxia, intracranial hemorrhage and cord around neck in sequence in the premature group, and were asphyxia, jaundice, fetal distress, intracranial hemorrhage and intrauterine infection in sequence in the full-term group. Besides auditory handicap. The frequency of spastic diplegia was higher in the premature group than in the full-term group (P<0.001), and the incidence of spastic hemiplegia was higher in the full-term group than in the premature group (P<0.01). There was no significant difference in dysgnosia, epilepsy and visual disturbance (P>0.05), but auditory handicap (P<0.05) between 2 groups. Conclusion The main clinical types of premature and full-term children with cerebral palsy were spastic diplegia and spastic hemiplegia respectively. The prevalence of auditory handicap was higher in preterm children

A Clinical and Mycological Studies on Tinea Pedis / 대한의진균학회지

BACKGROUND: Tinea pedis is the most common dermatophytosis in Korea. It has been increased gradually with time and the proportion of that in the aged has been significantly increased. OBJECTIVE: The aim of this study is to evaluate the clinical characteristics of tinea pedis according to the clinical types and their mycologic findings. METHODS: A clinical and mycological study was performed with 212 cases of tinea pedis among outpatients examined for 9 months from March 2005 to November 2005 at Department of Dermatology of the 11 University Hospitals in Korea. RESULTS 1. The age distribution showed patients in their 50s and 60s to be the most common. The ratio of male to female was 1.33:1 2. The most frequent clinical type was interdigital only type (55.2%), interdigital hyperkeratotic type (39.8%), vesicular type (2.8%) and interdigital vesicular type (2.2%), in descending order. There are no hyperkeratotic only type and hyperkeratotic vesicular type. 3. The duration of tinea pedis was longer than 5 years in 73.1%. The proportion of interdigital hyperkeratotic type was the highest in longer than 10 years of duration group than in other duration groups. 4. The rate of coexistent dermatophytosis with tinea pedis was 19.3%, and tinea cruris was the most common (10.3%). 5. The positive culture rate was 73.1%, and Trichophyton(T.) rubrum was the most common isolates (93.5%) followed by T. mentagrophytes var. mentagrophytes (3.9%) and T. mentagrophytes var. interdigitale (2.6%). CONCLUSIONS: All these findings suggest that the prevalence of tinea pedis in the aged was high, longer duration of the disease was more common and the rate of coexistent dermatophytosis increased. Further studies about tinea pedis and other dermatophytosis in the aged person will be necessary.

Oral Leukoplakia Related to Malignant Transformation / Oral Science International

Oral leukoplakia and its malignant transformation are reviewed in this article. Oral leukoplakia is defined as a predominantly white lesion of the oral mucosa that can not be characterized as any other definable lesion; however, the lesion must be confirmed histopathologically by biopsy in order to discuss malignant transformation of oral leukoplakia. Malignant transformation rates of oral leukoplakia range from 0.13 to 17.5%, while the rates of five-year cumulative malignant transformation range from 1.2 to 14.5%. Some reports found a high incidence of malignant transformation in older patients. Chewing tobacco and smoking are distinct risk factors particularly among males in certain countries; however, other countries have noted that females or non-smokers may be at risk of malignant transformation. HPV has been detected in oral dysplasia lesions and cancer in non-smokers. Conflicting reports have been presented regarding the malignant transformation of oral leukoplakia with epithelial dysplasia; however, we and some authors believe that epithelial dysplasia is an important factor in the malignant transformation of oral leukoplakia. The majority of researchers showed non-homogenous leukoplakia as a risk factor, although different terms have been used to describe these lesions. There may be several routes to malignant transformation of oral leukoplakia, including transformations induced by carcinogenesis due to betel quid chewing or smoking, or by HPV infection. While no definite treatment modalities for oral leukoplakia have been established, we suggest surgical therapy with an adequate safety-margin and well-timed evaluation as an appropriate treatment in preventing malignant transformation.

Correlation between Gross Motor Function and the Clinical Types and Complications of Children with Cerebral Palsy / 中国康复理论与实践

@#ObjectiveTo investigate the correlation between the gross motor function and the clinical types and complications of children with cerebral palsy (CP).MethodsThe gross motor function of 126 CP children were measured by Gross Motor Function Classification System (GMFCS). Then the correlation between gross motor function, and clinical types and complications was analyzed.ResultsThere was a strong correlation between GMFCS and clinical types and complications ( P<0.001). GMFCS evaluation showed that 55.1% spastic children were categorized into levels Ⅰ and Ⅱ; 53.8% of dyskinetic and 85.7% of mixed children were categorized into levels Ⅳ and Ⅴ; 55.4% of diplegic and total hemiplegic children were categorized into levels Ⅰ and Ⅱ; 67.4% of tetraplegic and 55.6% complex hemiplegic children were categorized into levels Ⅳ and Ⅴ; 100% children with normal developmental quotient (DQ) and 91.6% above borderline of DQ were classified into levels Ⅰ and Ⅱ. The mental impairment was more severe; the levels of GMFCS were more higher. There were more visual impairment, hearing disorder, speech disability, feeding problem and epilepsy in children with levels Ⅲ, Ⅳ and Ⅴ than that with levels Ⅰ and Ⅱ.ConclusionThere is a significant correlation between GMFCS and clinical type and complications of CP, and the categorization of GMFCS is higher, the complications are more.

Correlation between Gross Motor Function and the Clinical Types and Complications of Children with Cerebral Palsy / 中国康复理论与实践

@#ObjectiveTo investigate the correlation between the gross motor function and the clinical types and complications of children with cerebral palsy (CP).MethodsThe gross motor function of 126 CP children were measured by Gross Motor Function Classification System (GMFCS). Then the correlation between gross motor function, and clinical types and complications was analyzed.ResultsThere was a strong correlation between GMFCS and clinical types and complications ( P<0.001). GMFCS evaluation showed that 55.1% spastic children were categorized into levels Ⅰ and Ⅱ; 53.8% of dyskinetic and 85.7% of mixed children were categorized into levels Ⅳ and Ⅴ; 55.4% of diplegic and total hemiplegic children were categorized into levels Ⅰ and Ⅱ; 67.4% of tetraplegic and 55.6% complex hemiplegic children were categorized into levels Ⅳ and Ⅴ; 100% children with normal developmental quotient (DQ) and 91.6% above borderline of DQ were classified into levels Ⅰ and Ⅱ. The mental impairment was more severe; the levels of GMFCS were more higher. There were more visual impairment, hearing disorder, speech disability, feeding problem and epilepsy in children with levels Ⅲ, Ⅳ and Ⅴ than that with levels Ⅰ and Ⅱ.ConclusionThere is a significant correlation between GMFCS and clinical type and complications of CP, and the categorization of GMFCS is higher, the complications are more.

A Clinical and Mycological Study of Tinea Pedis / 대한의진균학회지

BACKGROUND: Tinea pedis is the most common dermatophytosis in Korea. It has been increased gradually with time. Its characteristics may change with social environments. OBJECTIVE: The purpose of this study is to evaluate the clinical characteristics of tinea pedis according to clinical type and its mycologic findings. METHODS: We performed clinical and mycological studies on 74 patients with tinea pedis among outpatients clinic of Department of Dermatology in Yeungnam University Hospital and Catholic Skin Clinic for 3 months, from January 2005 to March 2005. RESULTS AND CONCLUSIONS: 1. The age distribution showed patients in their 60s and older than 60s to be most common. The ratio of male to female was 1.32:1 2. According to clinical types, the ratio of interdigital type was the highest (50%), followed by interdigital combined hyperkeratotic type (44.6%), interdigital combined with vesicular type (4%) and vesicular type (1.4%). There are no hyperkeratotic type and hyperkeratotic combined vesicular type. 3. The duration of longer than 5 years of tinea pedis was 73%. The proportion of interdigital combined with vesicular type was more common in its duration of longer than 10 years than its duration of less than 10 years. The durations of vesicular type and interdigital combined vesicular type were more than 5 years. 4. The rate of family history of tinea pedis was 52.7%. The broader area of involved site in the patients was, the higher the positivity in family history. 5. The rate of coexistent dermatophytosis with tinea pedis was 82.5%, and tinea unguium was the most common (79.7%). 6. The positive rate of culture was 68.9%, and Trichophyton(T.) rubrum was the most common isolates (96%) followed by T. mentagrophytes (4%). Compared with previous studies, age of patients with tinea pedis was older and duration was longer, the rate of coexistent dermatophytosis was increased, especially in tinea unguium.

Association between the tumor necrosis factor gene polymorphisms and the clinical types of patients with chronic hepatitis B virus infection / 中华传染病杂志

Objective To explore whether the polymorphisms within the tumor necrosis factor alpha (TNF-?) and TNF-? gene are associated with the clinical types of patients with chronic hepatitis B virus (HBV) infection. Methods By using a restriction fragment length polymorphism (RFLP) assay of polymerase chain reaction (PCR) products, the single nucleotide polymorphisms (SNPs) within TNF-? and TNF-? gene among 56 patients with chronic severe hepatitis B and 71 patients with chronic mild hepatitis B or asymptomatic carriers as well as 90 healthy controls were analyzed. The TNF-? concentration of serum in 56 patients with chronic severe hepatitis B and 30 healthy controls were determined by radio immunity assay (RIA). Results The frequencies of the TNF1/2 genotype and the TNF2 allele were significantly increased in patients with chronic severe hepatitis compared with healthy controls (25% vs 11.1%,P=0.028;12.5% vs 5.6%,P=0.036) and patients with chronic mild hepatitis B and asymptomatic carriers (25% vs 8.5%,P=0.011;12.5% vs 4.2%,P=0.015). Furthermore, heterozygotes carrying TNF2 allele had significantly higher levels of serum TNF-? than homozygotes for the wild type allele among all patients with chronic severe hepatitis B (P

Clinical Features of Cerebral Palsy

Cerebral palsy is a non-progressive cerebral sensori-motor defect, acquired either prenatally or in an early life and evolves over the first few years. Until recently many people believed that asphyxia at birth was a major cause of cerebral palsy and that the prevention of asphyxia at birth by improving perinatal care would reduce the number of cerebral palsy children. However the incidence of cerebral palsy in children has remained steady or ever risen slightly. The real cause of cerebral palsy is still unbaron to us. This analysis was undertaken to determine the clinical features of cerebral palsy in Korea by the retrospective study of 98 children. Over a half of infants with cerebral palsy (64.2%) was recognized by parents before 1 year of corrected age, and their chief complaints were delayed developments or equinus foot deformities. The most common type of cerebral palsy was spastic type (64.2%) which was followed by athetoid (10.5%), ataxia and hypotonia types (4.2% each). The mixed type was 19.4% Among 98 cerebral palsies, the preterm infants were 42.9% and the infants with low birth weight were 41.4%. The cerebral palsies with low birth weight and preterm infants were more likely to have spastic diplegia. The most frequent abnormal primitive reflex was absent protective extension(78.3%). No significant associations of the type of cerebral palsy with primitive reflexes were found. An increased risk of cerebral palsy with increased maternal age was not observed in this study. Of 55 MRI findings, no abnormalities were seen in 27.2%, periventricular leukomalacias in 34.5%, brain atrophies in 21.8%, cerebral infarcts in 10.9%, intracerebral hemorrhage in 3.6%, and delayed myelinations in 1.8%. The periventricular leukomalacias were associated with the preterm infants in 63.2%.

A Clinical and Mycological Study of Tinea Pedis / 대한피부과학회지

BACKGROUND: In tinea pedis, the response of treatment and prognosis are different according to clinical types. Positivity in KOH mount and causative agent in culture are also different. OBJECTIVE: Our purpose was to evaluate the clinical characteristics and mycologic findings of tinea pedis according to the clinical type. METHODS: A clinical and mycological study was conducted with 97 cases of tinea pedis among out patients examined for 7 months from June 1994 to December 1994 at Yeungnam University Hospital and Catholic Skin Clizic, Taegu, Korea. RESULTS: 1. Age distribution showed patients in their fourth decade to be most common. The ratio of male to female was 1.2: 1. The distribution of patients by clinical type was interdigital type, interdigital combined with hyperkeratotic type, interdigital combined with vesicular type, hyperkeratotic type, and hyperkeratotic combined with vesicular type, in descending order. One to five years was the most comrrion duration of tinea pedis. Duration of tinea pedis was the shortest in the vesicular type, otherwis was longer in hyperkeratotic type. Rate of family history of tinea pedis was 54.6%. The larger the size of family was, the higher the positivity in family history. The rate of coexistent dermatiophytosis with tinea pedis was 39.1%, and tinea unguium was the most common one. 2. The isolated dermatophytis were T. rubrum, 90.7%, T. mentagrophytes, 7.2%, and T. rubrum rnixed with T. mentagrophytes, 2.1%. T. rubrum showed an even distribution in all clinical types of tinea pedis whereas T. mentanophytes was isolated only in the interdigital type, vesicular type, and interdigital combined with vesicular type. T. rubrum mixed with T. mentagrophytes was isolated in the interdigital combine with vesicular type. Distribution of dermatophytes was relatively even arnong the age groups. T. rubrum showed a relatively even distribution in duration of tinea pedis, but T. mentagrophytes was isolated in tinea pedis with shorter duration.