Longitudinal In Vivo Ultrasound Observations of the Surgically Repaired Zone II Flexor Digitorum Profundus Tendon

The link between the healing process and functional outcomes in the surgically repaired digital flexor tendon is poorly understood. This clinical note describes those gray-scale and power Doppler (PD) ultrasound parameters that can be used to document longitudinal change in the morphologic and dynamic properties of the surgically repaired zone II flexor digitorum profundus (FDP) tendon. The method is supported by ultrasound data obtained from three participants at five points in time post-surgically (two, four, six, 12 and 18 weeks). Longitudinal documentation of the ultrasound properties of echogenicity, defect size, tendon excursion and power Doppler signal is feasible and has the potential to explore the possible link between changes in the structural status of surgically repaired flexor tendons and associated clinical outcomes.     

不规则抗体筛查室内质控品的制备及初步应用

目的自制不规则抗体筛查室内质控品并进行初步应用。方法选择商品化单克隆Ig G类抗D原液作为强阳性质控品,其稀释液作为弱阳性质控品,不规则抗体阴性的献血员AB型血浆作为阴性质控品。将强阳性、阴性质控品连续测定20次,确定其靶值;将单克隆Ig G类抗D倍比稀释,确定红细胞凝集强度达到2+的最高稀释倍数作为弱阳性质控品的最佳稀释度,连续测定20次。质控品与待检标本同时按标准操作规程进行测定,每天测定1次,共6个月。结果强阳性质控品靶值为4+,弱阳性质控品靶值为2+,最佳稀释度为1∶500,其质控范围为1~3+。弱阳性质控品在6个月的使用过程中出控4次,强阳性、阴性质控品检测结果均在控。结论实验室自制不规则抗体筛查室内质控品可行,功能上能够完全满足对检测项目的质量控制要求。     

中医情志疏导护理联合艾灸治疗对术后病人生活质量的影响与分析

[目的]观察中医情志疏导护理联合艾灸治疗对术后病人生活质量的影响效果。[方法]60例择期手术病人采用区组随机化方法随机分配到对照组(G1)与干预组(G2)。G1组按常规护理操作要求进行护理;G2组则在常规护理操作基础上配合中医情志疏导护理及艾灸治疗。所有入选病人均在充分术前准备的情况下,严格遵照手术要求完成手术。并于术后第1天、第5天、第7天按《外科术后康复评价量表》进行评分,对比所有受试者前后评分的变化情况以评估疗效。[结果]护理干预前,两组组间基线特征均衡性良好(P>0.05)。护理干预后,两组中所有受试者第5天、第7天的术后康复评分与第1天比较,差异有统计学意义(P<0.05),且G2组的效果要明显优于 G1组(P<0.05)。[结论]中医情志疏导护理联合艾灸治疗可明显改善手术病人的生活质量,促进其术后康复。中医情志疏导护理联合艾灸治疗操作简便,病人依从性高。     

Iatrogenic brachial artery injury during pinning of supracondylar fracture of humerus: A rare injury

Complications following supracondylar fracture of humerus are well-known. Pre- and post-operative complications have been documented in the literature. Neurovascular injury due to fracture fragments following this type of fracture is described. Iatrogenic brachial artery during surgical treatment of this fracture is unknown to the literature. So we report a rare case of iatrogenic brachial artery injury during pinning of supracondylar fracture of humerus and try to create awareness to the surgeons that such injuries can occur with improper operative techniques.     

空心加压螺钉内固定治疗锁骨骨折

<正>2012年1月~2012年11月,我科采用空心加压螺钉和重建钢板内固定两种方法治疗50例锁骨骨折患者,现报道如下。1材料与方法1.1病例资料本组50例,男28例,女22例,年龄21~53岁,均为锁骨中1/3闭合骨折:短斜形骨折28例,横形骨折22例。分为两组:1空心加压螺钉组25例,男15例,女10例,年龄     

3种方法治疗老年不稳定性股骨转子间骨折的疗效比较

目的比较人工关节置换与髓内、外固定治疗老年不稳定性转子间骨折的疗效。方法手术治疗70例老年不稳定性股骨转子间骨折患者,根据手术方式不同分为股骨近端防旋髓内钉(PFNA)组(21例)、锁定钢板组(30例)以及人工关节组(19例)。对3组手术时间、术中出血量、住院时间、骨折相关并发症、术后深静脉血栓和肺部感染发生率以及术后12、24个月髋关节功能评分等资料进行比较。结果 70例患者均获得随访,时间24~50个月。PFNA组的手术时间(61.4 min±10.2 min)、术中出血量(196 ml±64.1 ml)均少于另两组(P0.05)。人工关节组的住院时间(16.3 d±3.9 d)、骨折相关并发症(5.2%)、术后深静脉血栓(5.3%)、肺部感染(10.5%)发生率均少于另两组(P0.05),术后12个月髋关节Harris评分优良率(84.2%)高于另两组(P0.05)。术后24个月髋关节Harris评分优良率3组比较差异无统计学意义(P0.05)。结论对于老年不稳定性股骨转子间骨折,人工关节置换术在改善近期髋关节功能及降低术后并发症上更有优势。     

Development and psychometric characteristics of the SCI-QOL Bladder Management Difficulties and Bowel Management Difficulties item banks and short forms and the SCI-QOL Bladder Complications scale

ObjectiveTo describe the development and psychometric properties of the Spinal Cord Injury – Quality of Life (SCI-QOL) Bladder Management Difficulties and Bowel Management Difficulties item banks and Bladder Complications scale.DesignUsing a mixed-methods design, a pool of items assessing bladder and bowel-related concerns were developed using focus groups with individuals with spinal cord injury (SCI) and SCI clinicians, cognitive interviews, and item response theory (IRT) analytic approaches, including tests of model fit and differential item functioning.SettingThirty-eight bladder items and 52 bowel items were tested at the University of Michigan, Kessler Foundation Research Center, the Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital, and the James J. Peters VA Medical Center, Bronx, NY.ParticipantsSeven hundred fifty-seven adults with traumatic SCI.ResultsThe final item banks demonstrated unidimensionality (Bladder Management Difficulties CFI = 0.965; RMSEA = 0.093; Bowel Management Difficulties CFI = 0.955; RMSEA = 0.078) and acceptable fit to a graded response IRT model. The final calibrated Bladder Management Difficulties bank includes 15 items, and the final Bowel Management Difficulties item bank consists of 26 items. Additionally, 5 items related to urinary tract infections (UTI) did not fit with the larger Bladder Management Difficulties item bank but performed relatively well independently (CFI = 0.992, RMSEA = 0.050) and were thus retained as a separate scale.ConclusionThe SCI-QOL Bladder Management Difficulties and Bowel Management Difficulties item banks are psychometrically robust and are available as computer adaptive tests or short forms. The SCI-QOL Bladder Complications scale is a brief, fixed-length outcomes instrument for individuals with a UTI.