Intraoperative fluoroscopy on femoral tunnel placement in the treatment of professional snow sports athletes with anterior cruciate ligament injury / 中华创伤杂志

Objective:To explore the clinical outcomes of intraoperative fluoroscopy on femoral tunnel placement in treating professional snow sports athletes with anterior cruciate ligament (ACL) injury.Methods:A retrospective case series study was used to analyze the clinical data of 13 professional snow sports athletes with ACL injury treated in the National Institute of Sports Medicine, General Administration of Sport of China from January 2016 to January 2019. There were 5 males and 8 females, aged 16-27 years [(18.5±3.0)years]. Intraoperative lateral fluoroscopy combined with quadrant method was performed for the accurate femoral tunnel placement in single-bundle ACL reconstruction by using autologous hamstring tendon in all patients. KT1000 side-to-side difference (KT1000-ssd), pivot shift test, International Knee Documentation Committee (IKDC) subjective score, Lysholm score, Marx activity scale and maximum extension and flexion resistance ratio of the involved and uninvolved knee were compared before operation (or before injury) and at 3, 6, 12 and 24 months after operation. Whether returning to the field, time taken in returning to the field and re-injury were recorded at each follow-up visit. ACL graft signal intensity ratio (SIR) in MRI of the involved knee was evaluated at postoperative 24 months.Results:All patients were followed up for 24-33 months [(25.8±2.7)months]. There were 7 patients with KT1000-ssd degree I, 5 with degree II and 1 with degree III before operation, compared to 12 patients with KT1000-ssd degree 0 and 1 with degree I at 3 and 6 months after operation and 13 patients with KT1000-ssd degree 0 at 12 and 24 months after operation. The pivot shift test was grade I in 8 patients and grade II in 5 before operation, compared to 11 patients with degree 0 and 2 with degree I at 3 months after operation and 12 patients with degree 0 and 1 with degree I at 6, 12 and 24 months after operation. IKDC subjective score was (68.0±4.3)points, (84.7±7.9)points, (94.6±3.3)points and (96.5±1.8)points at postoperative 3, 6, 12 and 24 months, respectively. Six months after operation, IKDC subjective score was significantly improved compared to the preoperative (48.3±25.0)points (all P<0.01). The Lysholm score was (63.4±6.6)points, (80.1±6.5)points, (93.8±4.6)points and (96.5±2.4)points at postoperative 3, 6, 12 and 24 months, respectively. Six months after operation, the Lysholm score was significantly improved compared to the preoperative (47.5±29.4)points (all P<0.01). The Marx activity scale was (7.4±0.5)points, (13.8±0.7)points, (14.6±0.8)points and (15.0±0.7)points at postoperative 3, 6, 12 and 24 months, respectively, significantly lower than (16.0±0.0)points before the injury (all P<0.01). The maximum extension resistance ratio of the involved and uninvolved knee was 0.60±0.10, 0.85±0.08, 0.91±0.06 and 0.97±0.04 at postoperative 3, 6, 12 and 24 months, respectively. Six months after operation, the maximum extension resistance ratio of the involved and uninvolved knee was significantly increased compared to the preoperative 0.57±0.18 (all P<0.01).The maximum flexion resistance ratios of involved and uninvolved knee were 0.64±0.09, 0.82±0.06, 0.89±0.04 and 0.94±0.06 at postoperative 3, 6, 12 and 24 months, respectively. Six months after operation, the maximum flexion resistance ratio of the involved and uninvolved knee was significantly increased compared to the preoperative 0.60±0.12 (all P<0.01). Thirteen athletes returned to the field within 12 months after operation with the time taken in returning to the field ranging from 5-12 months [(8.7±1.9)months]. There was no ACL re-injury at postoperative 24 months. The ACL graft SIR in MRI of the involved knee was 1.80±0.20 at postoperative 24 months. Conclusion:Intraoperative fluoroscopy on femoral tunnel placement in the treatment of professional snow sports athletes with ACL injury can significantly improve the knee joint stability, subjective function, sports performance and muscle strength within 6 months, and can help them return to the field within 12 months, and accelerates graft healing.

Explanining the vigor (relative and absolute) in seeds: the biological meaning behind the mathematician / Desvendando o vigor (relativo e absoluto) em sementes: o significado biológico por trás da matemática

Seed vigor is the totality of all properties that determine a rapid and uniform emergence and development of normal seedling under a wide range of conditions. However, the physiological quality within a seed lot is not homogeneous, generating a quality gradient between seeds. Thus, the vigor expressed by the final percentage of normal seedlings tends to underestimate the quality of the batch, considering the total number of seeds. One possible method for correcting such an effect would be to weight vigor by germination, generating an index called relative vigor. The index reflects the "success" of viable seeds in maintaining their potential under stress. In this context, this review article proposes the possibility of using a new measure for vigor and new interpretation of relative vigor, as well as providing the mathematical basis for its use.

O vigor de sementes é a totalidade de todas as propriedades que determinam uma rápida e uniforme emergência e desenvolvimento de plântulas normais sob umavasta gama de condições. Todavia, a qualidade fisiológica dentro de um lote de sementes não é homogênea, gerando um gradiente de qualidade entre as sementes. Assim, o vigor expresso pela porcentagem final de plântulas normais tende a subestimar a qualidade do lote, por levar em consideração o número total de sementes. Um método possível para corrigir tal efeito seria ponderar o vigor pela germinação, gerando um índice denominado vigor relativo. O índice reflete o "sucesso" das sementes viáveis em manter seu potencial sob uma situação de estresse. Neste contexto, o artigo de propõe a possibilidade de uso uma nova medida, para o vigor, e uma nova interpretação, o vigor relativo, além de dar as bases matemáticas para seu uso.

Evaluación in vitro de la capacidad biorremediadora de hongos filamentosos sobre petróleo crudo / Bioremediative Capacity Evaluation in vitro of the filamentous fungi on crude oil

Resumen Objetivo. Evaluar la capacidad biorremediadora de algunas especies de hongos filamentosos en suelos contaminados con petróleo crudo. Métodos. Se aislaron 138 cepas a partir de 90 cultivos primarios en muestras de suelos obtenidas en los municipios de Yondó (Antioquia), Acacías (Meta) y Tumaco (Nariño), se identificaron las especies por medio de claves taxonómicas y la amplificación por PCR de la región ITS ubicándose en siete géneros de hongos filamentosos. Del total de las especies se escogieron tres para el experimento que fueron: Neosartorya sp. Cepa A/N -1, Aspergillus sp. Cepa Y/As-3 y Rhizomucor sp. Cepa 1A/R-1; se realizó la micorremediación con la técnica de Landfarming modificado al diseñarse un microcosmos con 50g de suelo contaminado con petróleo crudo °API de 21.6 a concentraciones de 20.000 ppm y 30.000ppm para cada una de las especies en un inóculo de 300 conidios/ml en agua destilada, ajustado en cámara de Neubauer y las tres especies en consorcio en suelo contaminado con petróleo crudo °API de 21.6 a concentraciones de 40.000ppm, 60.000ppm, 80.000ppm y 100.000ppm con un inóculo de 300 conidios/ml. Se valoró el proceso por espectofotometría. Además se estableció las enzimas empleadas en la micorremediación y la citotoxicidad de las cepas empleadas. Resultado. La micorremediación realizada por las especies individuales fue en promedio entre 2 y 6 días y cuando se aplicaron las tres especies en consorcio se realizó en un promedio entre 6 y 10 días, la enzima empleada es peroxidasa y la citotoxicidad es negativa.

Abstract Objective. Evaluate the bioremediation capacity of some species of filamentous fungi in soils contaminated with crude oil. Methods. 138 strains were isolated from 90 primary culture in soil samples obtained in the municipalities of Yondó (Antioquia), Acacías (Meta) and Tumaco (Nariño), species were identified by means of taxonomic keys and PCR amplification of the ITS region located in seven genera of filamentous fungi. Of the total of the species, three were chosen for the experiment, which were: Neosartorya sp. Cepa A/N- 1, Aspergillus sp. Cepa Y/As -3 and Rhizomucor sp. Cepa 1A/R-1; Micoremediation was performed with the modified Landfarming technique when designing a microcosm with 50g of soil contaminated with crude oil API 21.6 at concentrations of 20,000 ppm and 30,000ppm for each of the species in an inoculum of 300 conidia / ml in water distilled, adjusted in Neubauer chamber and the three species in consortium in soil contaminated with crude oil API 21.6 at concentrations of 40,000ppm, 60,000ppm, 80,000ppm and 100,000ppm with an inoculum of 300 conidia / ml. The process was evaluated by spectrophotometry. In addition, the enzymes used in the micoremediation and cytotoxicity of the strains used were established. Result. The micoremediation performed by the individual species was on average between 2 and 6 days and when the three species were applied in a consortium it was carried out on average between 6 and 10 days, the enzyme used is peroxidase and the cytotoxicity is negative.

Evaluation the physiological quality of Brachiaria brizantha cv. BRS 'Piatã' seeds / Avaliação da qualidade fisológica de sementes de Brachiaria brizantha cv. BRS 'Piatã'

In a quality control program, seed vigor evaluation is of fundamental importance for the success of the program. The objective of this project was to evaluate the efficiency of several vigor tests to evaluate the physiological quality of Brachiaria brizantha cv. 'BRS Piatã' seed lots and to preview seedling emergence in the field. Ten grass seed lots of the B. brizantha cv. 'BRS Piatã' were evaluated by the following tests: germination, first count of germination, accelerated aging (43 °C/48 hours), cold test (seeds rolled in paper towel), seed water content before and after accelerated aging, electrical conductivity (50 and 75 mL, 25 °C and readings made 2, 4, 6, 8, and 24 hours after beginning the test), speed of germination index, and seedling emergence in sand substratum in the laboratory (26 ± 3 °C) and daily seedling counts between the 7th and the 21th day after sowing. The treatment replications were distributed in the laboratory according to a completely random design with four replications. Seedling emergence in the field data were analyzed according to a randomized complete block design. Treatment means were compared by the Scott Knott test, at the 5% level of probability. The tests for germination and first germination count, seedling emergence and first emergence count in the sand, and accelerated aging are useful to assess the vigor of seed batches of the piatã grass, and provide similar evidence to the seedling emergence in the field.

Dentro de um programa de controle de qualidade, a avaliação do vigor de sementes é fundamental e necessária para o sucesso da produção. O objetivo do presente trabalho foi verificar a eficiência de diferentes testes de vigor na avaliação da qualidade fisiológica de sementes de Brachiaria brizantha cv. BRS Piatã para a diferenciação dos lotes e previsão de emergência de plântulas em campo. Dez lotes de sementes de capim-piatã foram avaliados pelos seguintes testes: germinação, primeira contagem de germinação, envelhecimento acelerado (43 ºC/ 48 h), teor de água antes e após o envelhecimento acelerado, teste de frio (em rolo de papel), condutividade elétrica (50 e 75 mL, 25 ºC e leituras após 2, 4, 6, 8 e 24 h), crescimento de plântulas (em rolo de papel, 25 °C e encerrado no sétimo dia), primeira contagem, índice de velocidade de emergência e porcentagem de emergência de plântulas em substrato areia no laboratório (26 ± 3 ºC e contabilizando-se a porcentagem de plântulas emersas diariamente dos sete aos 21 dias após a semeadura) e emergência de plântulas em campo (21 dias). Adotou-se o delineamento inteiramente casualizado com quatro repetições. A emergência de plântulas em campo foi analisada em blocos casualizados. As médias dos tratamentos foram comparadas pelo teste de Scott Knott, a 5% de probabilidade. Os testes de germinação e primeira contagem de germinação, emergência e primeira contagem de emergência de plântulas em areia e o envelhecimento acelerado são eficientes na avaliação do vigor de lotes de sementes de capim-piatã, fornecendo informações semelhantes à emergência de plântulas em campo.

Discussion on the Connotation and Countermeasures of the Development of Nursing in the Social Service Field Under the Strategy of Healthy China / 中国医院管理

In the new situation of deepening medical and health system and promoting the health of China and successful aging,the health of China should be a guide for the development of nursing.The paper described the developmental status of nursing and new requirements,discussed the necessity and operability of the development of nursing in the field of social service.

Needs for disaster medicine: lessons from the field of the Great East Japan Earthquake

PROBLEM: The Great East Japan Earthquake, which occurred in Tohoku, Japan on 11 March 2011, was followed by a devastating tsunami and damage to nuclear power plants that resulted in radiation leakage. CONTEXT: The medical care, equipment and communication needs of four Disaster Medical Assistance Teams (DMAT) during four missions are discussed. DMATs are medically trained mobile teams used in the acute phase of disasters. ACTION: The DMATs conducted four missions in devastated areas from the day of the earthquake to day 10. The first and second missions were to triage, resuscitate and treat trauma victims in Tokyo and Miyagi, respectively. The third mission was to conduct emergency medicine and primary care in Iwate. The fourth was to assist with the evacuation and screening of inpatients with radiation exposure in Fukushima. OUTCOME: Triage, resuscitation and trauma expertise and equipment were required in Missions 1 and 2. Emergency medicine in hospitals and primary care in first-aid stations and evacuation areas were required for Mission 3. In Mission 4, the DMAT assisted with evacuation by ambulances and buses and screened people for radiation exposure. Only land phones and transceivers were available for Missions 1 to 3 although they were ineffective for urgent purposes. DISCUSSION: These DMAT missions showed that there are new needs for DMATs in primary care, radiation screening and evacuation after the acute phase of a disaster. Alternative methods for communication infrastructure post-disaster need to be investigated with telecommunication experts.

El trabajo de campo: clave en la investigación cualitativa / Field Work: Key to Qualitative Research / O trabalho de campo: fondamento da pesquisa qualitativa

Objetivo: destacar la experiencia de la inserción al campo no sólo como la forma de recolectar información y determinar la calidad de los datos en que se basan los hallazgos, análisis y conclusiones, sino, también como elemento integrador del proceso de investigación que permita realizar una lectura de la realidad más específica. Método: a través de la investigación Experiencias de las adolescentes embarazadas en la localidad de Kennedy en la ciudad de Bogotá. Deseando el embarazo pero no tan pronto, se describen el estudio cualitativo y los antecedentes de la investigación, y se presentan las fases propias de la inserción. Conclusión: como método, la inserción al campo trasciende el acceso al dato; exige una acción dialéctica entre la teoría y la práctica, ya que el trabajo de campo requiere una formación teórico-metodológica y, al mismo tiempo, se sustenta en diversas técnicas y herramientas para la investigación.

Objective: Highlight the experience of going into the field, not only as a way to gather information and to determine the quality of the data on which findings, analysis and conclusions are based, but also as an integrating element of the research process that allows for a more specific interpretation of reality. Method: Experiences of Pregnant Teens in the Kennedy District of Bogota: Wanting to Become Pregnant But Not so Soon describes the qualitative study and the background for the research, in addition outlining the stages that involved field work. Conclusion: As a method, going into the field implies more than access to data. It demands dialectic action between theory and practice, as field work requires theoretical-methodological training and preparation, besides being based on a variety of research techniques and tools....

Objetivo: realçar a experiência de integração no campo não apenas como uma maneira de coletar informação e determinar a qualidade dos dados que sustentam as descobertas, análises e conclusões, mas também como um elemento do processo de pesquisa que permite uma leitura específica da realidade. Método: na investigação Experiências de adolescentes grávidas na localidade de Kennedy, em Bogotá. Desejando a gravidez, mas não tão cedo, descrevemos o estudo qualitativo e os antecedentes da investigação e apresentamos os estágios da inserção. Conclusão: como método, a inserçã no campo vai além do acesso aos dados, exige ação dialética entre teoria e prática, posto que o trabalho de campo requer formação teórica e metodológica porque se baseia em várias técnicas e ferramentas de pesquisa....

O perfil de competências do trabalhador de nível técnico no campo das vigilâncias / The skills profile of the worker in the field of technical surveillance

Diante da necessidade de implementação do processo de descentralização das vigilâncias, muitos trabalhadores de nível médio vêm sendo transferidos do nível estadual para o municipal, assim como outros vêm sendo contratados pelos municípios para atuarem na estruturação desses serviços. Muitos, sem terem tido acesso à formação específica para atuação na área. Diante da política de desenvolvimento dos trabalhadores do SUS surge a necessidade estratégica de promover a sua educação profissional. A Escola Técnica de Saúde Profª Valéria Hora, responsável pela educação profissional dos trabalhadores de nível médio do SUS, em Alagoas, não tem experiência anterior em formação profissional no campo das vigilâncias. Tal fato motivou esse estudo, que teve como objetivo: delinear o perfil de competências dos trabalhadores de nível técnico do campo das vigilâncias, a partir do conhecimento e análise do processo de trabalho. O estudo foi aplicado em seis municípios selecionados por sorteio, onde se buscou conhecer e interpretar a sua realidade, com o foco nas seguintes categorias de análise: Quem são esses trabalhadores, o que fazem e quais suas dificuldades e necessidades. Foram ouvidos os gestores municipais de saúde em relação às suas percepções e expectativas sobre a prática desses trabalhadores. Observou-se que 85% da força de trabalho que integra o campo das vigilâncias no universo estudado é de pessoal de nível médio, sendo que 100% não tem formação específica. Vêm sendo capacitados através de treinamentos para determinados fazeres, evidenciando uma preparação para atuar em um mero recorte da realidade. Analisando-se os documentos oficiais, observou-se que de forma geral as atribuições definidas para eles, vêm sendo de certa forma realizadas...

In order to face with the implementation the surveillance’s decentralization, many midlevel workers are being moved from the state level to municipal level and others have been hired by municipalities to act in the structuring of those services. Many of them have had no access to general or specific education in the area. From the SUS’ workers political development Law comes the strategic needs to promote vocational education to these workers. However, the Technical School of Health Prof. Valéria Hora, which is responsible for the education of professional-level workers of SUS in the state of Alagoas, has no previous experience in training in the field of surveillance. This fact hasmotivated this study, which has the objective to: outline the skills profile of workers in the technical field of surveillance, based on knowledge and analysis of their work process. It is an exploratory study of qualitative nature, applied in six cities selected by draw, where sought to know and interpret the reality of these workers with a focus inthe following categories of analysis: a) Who are these workers; b) What they do and what are their difficulties and their needs. Were heard also the local health managers, regarding to their perceptions and expectations about the practice of these workers. It was observed that 85% of the workforce that integrates the field of surveillance in the universe studied is mid-level staff, and 100% have no specific training. They have been empowered through training to specific issues, showing a preparation of the worker towork only in a mere detachment from reality. By analyzing the official documents, it was observed that in general the tasks set for these workers, have been carried out. Often without understanding of reality as a whole, without knowing the results of theiractivities and tasks performed as required by their coordinators, setting that in fact they are treated as mere executors of the technical...

Estratégias para distribuição e fixação de médicos em sistemas nacionais de saúde: o caso brasileiro / Strategies for distribution and fixation of physicians in national health systems: the Brazilian case

INTRODUÇÃO: A distribuição geográfica de médicos é um problema com que se defrontam os sistemas nacionais de saúde e, no Brasil, tem se tornado um dos desafios para a consolidação do Sistema único de Saúde (SUS). A análise dos determinantes dessa distribuição está fundamentado em abordagens sobre o mercado de trabalho em saúde e no médico sua formação ou oferta inserido no contexto histórico, político, social e institucional em que são construídos. O referencial de análise proposto neste estudo tem como objetivo evidenciar os fatores e condicionantes que interferem na distribuição e fixação de médicos identificar possíveis estratégias de intervenção que podem ser aplicadas à realidade brasileira, no contexto das políticas públicas.OBJETIVO: O mote para essa discussão é a compreensão de que a forte concentração geográfica dos profissionais e dos serviços impede a concretização dos princípios que regem o Sistema Único de Saúde, particularmente no que se refere à universalização, à integralidade e à própria descentralização. As estratégias tentadas pelo governo brasileiro também são abordadas, mais especificamente, o Projeto Rondon, o Programa de Interiorização das Ações de Saúde e Saneamento (PIASS) e o Programa de Interiorização do SUS (PISUS). MATERIAL E MÉTODO: Essa análise é complementada com um estudo de caso sobre a experiência recente no campo da política pública em saúde destinada a minimizar a má distribuição de médicos no território nacional: o Programa de Interiorização do Trabalho em Saúde (PITS), implementado pelo Ministério da Saúde em 2001. RESULTADOS: Sua condição de estratégia inédita na política de recursos humanos em saúde em nosso país permitiu identificar aspectos relevantes para qualquer iniciativa que pretenda fortalecer a distribuição de profissionais de saúde, para além dos grandes centros urbanos. CONCLUSÃO: Por fim, o estudo oferece um referencial de análise para a distribuição e a fixação de médicos, construído a partir dos elementos contemplados na revisão da literatura, na discussão teórica, no aporte das experiências nacionais e internacionais e nos resultados obtidos no estudo de caso.

INTRODUCTION: The medical geographical distribution is a matter that challenges the nationals systems of health and, Brazil, its becoming one of the main challenges to face to consolidate the SUS (Sitema Único de Saúde Unique System of Health). OBJECTIVE: The analysis of the determinative ones of this distribution is based on approaches about the work market in health and the doctor his formation or offer inserted in the historical context, politician, economic, social and institutional where they are constructed. The referential of analysis considered in this study has as its objective to make evident the factors and conditioning matters that interfere with the distribution and retention of doctors and to identify possible strategies of intervention that they can be applied to the Brazilian reality, in the context of the public politics. The motto for this discussion is the understanding of that the strong geographic concentration of the professionals and of the services it obstructs the concretion of the principles that conduct the SUS (Unique System of Health), particularly as for the universalization, to the integrality and to the proper decentralization. The attempted strategies by the Brazilian government also are focused, emphasizing the Rondon Project, the PIASS (Program of Actions of health and Sanitation in the interior area of Brazil rural areas). MATERIAL AND METHODS: This analysis is complemented with a case study on the recent experience in the field of the public health politics destined to minimize the bad distribution of doctors in the national territory: the PITS (a program to stimulate and increase work in the field of health in the interior area of Brazil), implemented by Ministry of Health in 2001. RESULTS: Its condition of unheard-of strategy in the politics of human resources in health in our country allowed identifying relevant aspects for any initiative that intends to fortify the distribution of health professionals towards out of the great urban centers. CONCLUSION: Finally, the study offers a referential of analysis for the distribution and retention of doctors, constructed from the elements contemplated in the bibliographic revision, in the theoretical discussion, in the related national and international experiences and in the results gotten in the case study.

Application of Portable X-ray Machine in the Field / 医疗卫生装备

Through making a summary of using the portable X-ray machine in the earthquake relief,the equipment of the advantages and disadvantages in the field are analyzed and introduces the problems and solutions in application,and gives some improved suggestions for tripod.

Control system design of the medical oxygeng enerator in the field trailer / 医疗卫生装备

This paper introduces the control system design of the medical oxygen generator in the field trailer.Based on a series of experiments,the results prove that the control system can meet the purpose of the design and can fulfill the need of the equipment.