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Though there is a great progress in research of medical ethics in China, a gap still remains between China and the developed countries now. Medical ethics committees are established one after another in many hospitals, but the level of standardization construction and ethical review level differ in thousands ways. The construction of ethical review platform on TCM can standardize the construction and investigation procedure, and can further enhance the ethical review level of medical ethics committee. Among them, institutional improvement of regulations and procedures can be acquired in short time, but the enhancement of ethical review level needs a long way to go. This article aimed to probe the thinking and methods on the enhancement of ethical review level through the practice and experience of the construction of TCM ethical review platform.
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Objective To evaluate the long-term results of minimal incision osteotomy for hallux valgus.Methods From February 1996 to May 1999,372 cases(705 feet)with hallux valgus were treated with minimal incision osteotomy.Seventy-nine cases after surgery were followed up for more than 5 years,including 6 males(10 feet)and 73 females(140 feet)with an average age of 47 years(range,13-75 years).The average follow-up time was 7.5 years(range,5.3-13.2 years).The preoperative and postoperative hallux valgus angles(HVA),intermetatarsal angles(IMA),the tibial sesamoid position(TSP),American orthopedic foot and ankle society(AOFAS)score,range of movement of the first metatarsophalangeal joint,and lateral metatarsalgia etc.were observed and measured.And the clinic outcome were studied and evaluated.Results Based on Wen Jian-min's clinic curative effect evaluation criterion(2001),56 feet(37.3%)were excellent,88 feet(58.7%)good ,6 feet(4.0%)fair.The rate of excellent or good was 96.0%(144/150).The postoperative mean AOFAS score was 84.20±4.32 points(range,60-100 points).The mean HVA decreased from 33.28 to 12.31 degrees,the mean IMA from 11.75 to 6.80 degrees.The TSP was corrected from an average preoperative grade of 4.29 to a grade of 3.07 at final follow-up.There are no nonunion or delayed union of osteotomy,avascular necrosis of the 1st metatarsal head,infection,hallux varus.Four feet(2.7%)had numbness in the medial of the big toe.The 1st metatarsophalangeal joint range of motion decreased from 70.20 to 69.53 degrees.There were 97 feet(64.7%)with the 2-5 metatarsalgia before operation,and 35 feet(23.3%)disappeared,54 feet(36.0%)improved,8 feet(5.3%)aggravated after operation.Conclusion Minimal incision osteotomy technique is sound and reliable method to treat hallux valgus.The osteotomy technique is simple,and could provide satisfactory long-term results with lower complication rate.
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Objective To observe the degree of joint flexion and extension of elbow and knee joints of moderate skeletal fluorosis patients before and after treatment and to assess the effects of Gun's MaQian decoction in treating moderate skeletal fluorosis. Methods 54 moderate skeletal fluorosis patients were randomly recruited into a treatment group and a control group. The treatment group was treated with Gun's MaQian decoction initially, and changed to be treated with GuKangNing capsule after 8 weeks' treatment. The control group was treated with placebo at first, and also changed to be treated with GuKangNing capsule after 8 weeks. Results Joint flexion and extension of elbow was improved greatly in both groups after the treatment, while the treatment group showing better effects than the control group (P<0.05). The improvement of joint flexion and extension of knee had not showed a statistical significance after the treatment. A 24 weeks follow-up to the joint flexion and extension of both elbow and knee revealed obvious improvement and the difference between the two groups were significance (P<0.05). Conclusion Gun's MaQian decoction can improve the flexion and extension of elbow and knee in moderate skeletal fluorosis patients.