Is Elective Implant Removal after Fracture Healing Beneficial? – A Prospective Cohort Study

@#Introduction: Elective implant removal following healed extremity fractures remains controversial. This study aimed to evaluate the reasons and outcomes of implant removal after uneventful healing of limb fractures. Materials and methods: This is a prospective single-centre observational cohort study. Patients who sustained upper or lower extremity fractures that were fixed and healed uneventfully were included in the study when they elected to remove the implants. Patients were followed for six months post-operatively. Outcomes were assessed with patient satisfaction, symptoms resolution, and complications. Results: A total of 43 patients were recruited from October 2016 to March 2019. Thirty-six patients (37 implants) were symptomatic. Pain and prominence were the most common complaints, present in 59.5% and 33.3% of patients, respectively. Cold weather pain was also not uncommon (19.0%). Pain improved in 91.3% of the patients who complained of pain. The 94.6% symptomatic patients had at least partial resolution of pre-operative symptoms. All the patients who completed follow-up were satisfied with the procedure. In two patients, there were broken and retained screws intra-operatively. Post-operative complication rate was 23.8%, although no major complications occurred. Conclusions: Implant removal after uneventful healing of extremity fractures is a safe procedure that conferred a predictable relief of symptoms and satisfactory outcomes in most.

Effects of extreme high and low temperatures on admission risk of acute ischemic stroke and its etiology subtypes: a time series analysis in Wuhan, China / 国际脑血管病杂志

Objective@#To investigate the effects of extreme high and low temperatures on admission risk of acute ischemic stroke (AIS) and its etiology subtypes.@*Methods@#From January 1, 2016 to December 31, 2017, the data of inpatients with AIS from Zhongnan Hospital of Wuhan University and the meteorological data and air pollution data from China Meteorological Data Network in the same period were collected continuously. According to TOAST etiology criteria, the patients were divided into large artery atherosclerosis (LAA), small vessel occlusion (SVO), cardioembolism (CE), and stroke of other etiology (SOE). A time series analysis of the distributed lag model was used to investigate the effects of extreme high and low temperatures on the admission of patients with AIS and its etiology subtype, and air pollution, air pressure, humidity, and wind speed were used as confounding factors to exclude interference.@*Results@#A total of 1 413 patients with AIS were enrolled, including 906 men (64.4%), age 67.7±12.8 years. The thresholds of extreme low temperature (1%, 5% and 10% of the average temperature) were 0.7 ℃, 3.3 ℃, and 4.9 ℃. The thresholds of extreme high temperature (90%, 95% and 99% of the average temperature) were 29.2 ℃, 31.6 ℃, and 32.9 ℃. Extreme high temperature increased the risk of hospitalization in patients with AIS (lag 0 day; relative risk [RR] 1.54, 95% confidence interval [CI] 1.01-2.34). It was mainly related to the increased risk of hospitalization in patients with CE subtype (lag 0 day; RR 7.64, 95% CI 1.19-49.09). There was no significant correlation between the extreme low temperature and the risk of hospitalization of AIS (lag 2 days; RR 0.99, 95% CI 0.71-1.37), but it significantly increased the risk of hospitalization in patients with LAA subtypes (lag 2 days; RR 3.04, 95% CI 1.33-6.95), and it was still statistically significant at lag 3 days (RR 2.87, 95% CI 1.57-5.25) and lag 4 days (RR 2.19, 95% CI 1.15-4.15).@*Conclusion@#Extreme high temperature may increase the risk of hospitalization in patients with AIS and CE subtypes, while extreme low temperature may increase the risk of hospitalization in patients with LAA subtypes.

First aid cardiopulmonary resuscitation at the exit of capsule and strategy coping with the "Shenzhou 11"spacecraft / 中华急诊医学杂志

Objective To summarize the medical security experience in first-aid and resuscitation for astronauts at the exit of capsule after the spacecraft returns to the main landing site in the process of human spaceflight in China,and thus to provide a powerful security measures for Chinese aerospace medicine.Methods The medical support experiences were summarized in human spaceflight from "Shenzhou V" to "Shenzhou X",relevant reports on emergency rescue and resuscitation were consulted in in-orbit process and after emergency return and landing for domestic and foreign astronauts,astronauts' physiological changes in cardiopulmonary resuscitation were analyzed during emergency return,and then,corresponding strategies were proposed and tested in practice (actual combat) by combining with the flight characteristics of the spacecraft "Shenzhou XI".Results On the basis of the original emergency treatment,the countermeasures for the cardiopulmonary resuscitation were proposed after the spacecraft returned to the main landing site in human spaceflight,the emergency equipment was adjusted,the emergency procedures were optimized,and anti-fog glidescopes were added,laryngeal masks were introduced to perform supraglottic ventilation as the quickest and most effective airway opening measure on site.In addition,ultrasound examination was applied in practice as an important treatment and assessment method for basic life support and advanced life support.All these could ensure the rescuing ability on cardiopulmonary resuscitation during their stay in space for the medium-term and after their return to the main landing site.Conclusions During the return of the astronauts of the spacecraft "Shenzhou XI" to the main landing site,the first aid and support program had been improved specifically and the process had been optimized to ensure the successful completion of medical security mission of China's human spaceflight.

"The specialty and coping strategies of ""ShenZhou 11"" astronauts' rescue and medical aid" / 中华急诊医学杂志

Objective To ensure the medical security of the astronauts,new targeted strategies were adopted after summarizing the experience in Chinese astronauts rescue and medical aid at the main landing site,the specialty and characteristics of landing were analysied.Methods Search the publications about astronaut medical aid domestic and abroad,summarize the rescue and medical aid experiences from Shenzhou 5 to Shenzhou 10.In consideration of prolonged on-orbit time,the cold weather conditions at the landing zone of Shenzhou 11,new targeted strategies were presented.Results On the basis of the original helicopter emergency platform and first aid equipment,the emergency aid procedures were optimized,personal warm clothing,a heat preservation box,insulation blanket,self-heating pads and intraosseous rapid infusion system were used to ensure the medical security of astronauts in cold weather at the main landing site.Conclusions With the procedures optimized and the targeted strategies performed,the astronauts' s rescue and medical aid project was fully meet the cold and complex conditions at main landing site.

Mycota on Some Agarics Found in Assiut

This study is aimed to investigate about the fungal flora of some agaric fungi in Assiut, Egypt wild mushroom were collected during cold weather from November to February in the years 1995 and 1996 respectively. Twenty three species and one variety belong to 12 genera in 7 families of the order Agaricales from Assuit were identifled. The common genera were Agaricus, Macrolepiota and Corprinus. From the preceeding genera, four species from each genus were collected. Agaricus bitorquis, A. campestris, A. hortensis, A. perraus, Macrolepioya, M. rhacodes, M. rhacodes var. Hortensis, Marcrolepiota sp., Coprinus afamentarus, C. comatus, C. picaceus and C. nosoustii.