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The present study analyzes the use of the online teaching platform of China Medical University during the COVID-19 epidemic, excavates the teaching difficulties encountered in online teaching, and shares the experience of implementing "1+M" mode of mixed online teaching platform by introducing a variety of online teaching platforms. Monitoring of teaching quality has been initiated on time, and the key tasks of online teaching have been straightened out in time, which has effectively improved the quality of online teaching, providing references and basis for further advancing the reform of higher medical education in China.
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ObjectiveTo analyze the risk factors related to perforation of lateral wall by lower cervical pedicle screw instrumentation in the treatment of cervical spinal disorders. MethodsA retrospective review was made to analyze 214 cervical vertebral injury patients ( 1 024 pedicle screws were used) treated with pedicle screw instrumentation at C3-7 from July 2004 to July 2009. Lateral walls of 18 patients were perforated (a total of 28 pedicle screws). The surgeons assessed the position and the angle of the screw in the pedicle, and the relation and the distance between the screw and the pedicle walls by carefully probing intraoperative walls of cervical pedicles and studying postoperative thin-slice computed tomography (CT) scan of the fixed vertebral segments of the cervical spine. The data of patients with lateral wall perforation was recorded and analyzed statistically. ResultsPerforation of the lateral wall occurred in 18 patients (28 pedicle screws). Backward step by step Logistic regression analysis was used and two variables were selected in the end. ConclusionsRatio variance between inner and lateral wall is the risk factor of perforation in the lateral wall associated with lower cervical pedicle screw instrumentation, while the angle variance between implanted screws and CT measurements is the protection factor of perforation in the lateral wall.
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Objective To analyze the complications of lower cervical pedicle screw fixation in treatment of the cervical spine disorders and discuss the operative technique. Methods A retrospective study was made in 104 patients with different cervical injuries treated by C3-7 pedicle screw fixation (total use of 624 screws) from July 2004 to March 2008. One stage posterior reduction and fixation using lower cervical pedicle screw-rod system or screw-plat system were performed in 66 traumatic patients and the nerve condition was evaluated by Frankel criteria system. For 46 non-traumatic patients, laminoplasty or laminectomy was performed for decompression, and cervical pedicle screw-rod system or screw-plat system were used in deformity correction and stability reconstruction. Based on exploration to quadric walls of vertebral pedicle during operation, postoperative thin-slice CT scan along operative vertebra segments' pedicle and bilateral oblique position X-ray of cervical spine in all patients, we evaluated screw location, screw angle as well as the distance and the relation between the screws and the internal pedicle wall or lateral wall. Results In this study, the lower cervical pedicles of 104 patients were fixated with 624 screws including 77 screws (12.34% ) for pedicle wall damage, 68 screws (10.8% ) for the lateral wall injury, 56 screws (8.97% ) for grade Ⅰ violation of pedicles, 12 screws (1.92% ) for grade II violation of pedicles Ⅱ violation of pedicles and 9 screws (1.44% ) for inferior wall injury of cervical pedicle. The follow-up lasted for 3-24 months (average 9. 8 months), which showed breakage of two screws (0.32% ) and loosening of one screw (0.16% ). Conclusions Lower cervical pedicle screw fixation has relatively low incidence of complications and is a safe operation. The complications can be minimized by sufficient preoperative imaging studies of the pedicles, familiar with the feature of opography and reasonable surgery technique.
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BACKGROUND: Traditional repair for Achilles tendon rupture has disadvantages of long cast immobilization times, poor outcomes and many complications.OBJECTIVE: To explore the safety and efficacy of early isokinetic rehabilitation training for patients after repair of Achilles tendon ruptures.METHODS: A total of 11 patients with Achilles tendon ruptures received treatments at the Department of Orthopedics, East District of Qingdao Municipal Hospital, from September 2007 to September 2009, were included. Nine of them underwent 8-week isokinetic exercises by using lsomed-2000 at 4 weeks after tendon repair. The evaluative indicators included Arner-Lindholm score, the ankle range of motion, and extensor-flexor peak torque.RESULTS AND CONCLUSION: The follow-up averaged 6 months, ranging from 3 to 12 months. The excellent and good rate of Arner-Lindholm score was 88.9%. The results showed a significant improvement in the ankle range of motion and extensor-flexor peak torque (P < 0.05). There were no infection or re-rupture cases. It is indicated that early isokinetic rehabilitation is safe and effective for patients with Achilles tendon ruptures at 4 weeks postoperatively. It provides evidence for early rehabilitation in patients with Achilles tendon ruptures.
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Objective To introduce the method of reconstructing posterolateral complex injury of the knee with the autogenous middle 1/3 of biceps femoris tendon and gracilis and evaluate its short-term outcome. Methods There were 21 cases of posterolateral complex injury of the knee reconstructed with the middle 1/3 of biceps femoris tendon and gracilis from January 2003 to December 2006. There were 13males and 1 female at age range of 18-49 years ( mean 34.3 years). The reconstructed ligaments included popliteal tendon, lateral collateral ligament and poplitrofibular ligament. An autogenous folded gracilis tendon was extracted and placed through trastibial bony tunnel from anterolateral to the posterior condylar of the tibia to reconstruct the popliteal tendon. An autogenous folded middle 1/3 of biceps femoris tendon was fixed in the isometric bony tunnel of the femoral lateral condyle. The anterior half was used to reconstruct the lateral collateral ligament, and the posterior half to reconstruct the poplitrofibular ligament. The posterolateral stability of the knee was evaluated mainly through examination varus instability of knee and external rotation range of leg. Results All cases were followed up for average 26 months (6-24months). Lysholm score of the knee was (43 ± 2) points preoperatively and (90 ± 3 ) points half year after operation, with significant improvement. Conclusions PCL injury may result in functional deficiency of the injured extremity. While the autogenous middle 1/3 of biceps femoris tendon and gracilis can yield a stable knee with good function, mini-trauma and satisfactory clinical results in reconstructing the posterolateral complex of the knee joint.