《Lower Limb Deformities》出版发行

Sihe Qin(秦泗河), Jiancheng Zang(臧建成), Shaofeng Jiao(焦绍锋), Qi Pan(潘奇)主编的《Lower Limb Deformities:Deformity Correction and Function Reconstruction》一书已于2020年4月由Springer出版发行。全书分为18章,共182 088字,附精美图片2 656张,以临床常见与少见的下肢畸形残缺为主线,从脊髓灰质炎后遗症、脑性瘫痪、脊柱裂后遗下肢畸形、创伤后遗症到感觉运动神经元病等神经源性肢体畸形,以及成骨不全、先天性胫骨假关节等,涵盖了100多个病种,涉及的治疗主要基于Ilizarov技术、Paley矫形外科原则和秦泗河骨科自然重建理论、一路两线三平衡下肢矫形外科原则,包括了完整的临床思维、术前评价设计、技术理念、操作技巧和系统化的临床管理流程。     

《Lower Limb Deformities:Deformity Correction and Function Reconstruction》新书介绍

正由国家康复辅具研究中心附属康复医院秦泗河教授团队主编的中国第一本英文版下肢畸形外科著作《Lower Limb Deformities:Deformity Correction and Function Reconstruction》(ISBN:978-981-13-9603-8)正式出版。本书分为18章,共182 088字,附精美图片2 656张,以临床常见与少见的下肢畸形残缺为主线,从脊髓灰质炎后遗症、脑性瘫痪、脊柱裂后遗下肢畸形、创伤后遗症到感觉运动神经元病等神经源性肢体畸形,以及成骨不全、先天性胫骨假关节等等分列,涵盖了100多个病种,所涉及的治疗主要基于Ilizarov技术、Paley矫形外科原则和秦泗河骨科自然重建理论、一路两线三平衡下肢矫形外科原则,包括了完整的临床思维、术前评价设计、技术理念、操作技巧和系统化的临床管理流程。     

Does Surgical Hip Dislocation and Periacetabular Osteotomy Improve Pain in Patients With Perthes-like Deformities and Acetabular Dysplasia?

BackgroundPatients with symptomatic residual Perthes-like deformities may present with a combination of structural abnormalities including a large aspheric femoral head, short and wide femoral neck, high greater trochanter, and acetabular dysplasia. Sometimes, the hip is further compromised by concurrent symptomatic femoroacetabular impingement (FAI) (proximal femoral deformities) and structural instability (acetabular dysplasia).Questions/purposesWe therefore sought to characterize (1) the intraoperative findings; (2) radiographic correction; and (3) early patient-reported outcomes, complications, and failures of treating complex Perthes-like hip deformities with combined surgical dislocation and periacetabular osteotomy (PAO).MethodsWe performed 694 hip preservation procedures between November 2006 and August 2010. Of these, 46 had residual Perthes-like hip deformities, defined as proximal deformity consistent with residual Perthes and a history of Perthes disease or treatment of pediatric hip dysplasia. Of these, we report on 16 patients (16 hips) with residual Perthes-like hip deformities and associated acetabular dysplasia (structural instability, defined as radiographic evidence of acetabular dysplasia with intraoperative confirmation of instability). These 16 patients were treated with a combined surgical hip dislocation to comprehensively address intraarticular and extraarticular sources of FAI and PAO to address structural instability and were analyzed at a minimum 24-month followup (median, 40 months; range, 24–78 months). No patients in this series were lost to followup. Ten patients’ hips had previous surgical treatment, including six with previous osteotomy. Operative findings were extracted from standardized prospectively collected intraoperative data collection forms. Radiographic correction was evaluated with established methods (lateral center-edge angle, anterior center-edge angle, acetabular inclination, center-to-trochanter distance) and clinical outcomes were measured with the modified Harris hip score (mHHS) as well as by prospectively recorded data on patient complications and followup.ResultsAcetabular labrochondral abnormalities included labral hypertrophy in all hips and labral and/or articular cartilage lesions requiring treatment in 13 hips. Radiographic analysis demonstrated consistent radiographic correction. The median preoperative mHHS improved from 64 to 92 at a median followup of 40 months (p < 0.001). Fourteen patients (14 hips) had a good or excellent clinical result. Two patients (two hips) were classified as failures based on mHHS less than 70 (n = 1) or conversion to total hip arthroplasty (n = 1).ConclusionsCombined surgical hip dislocation and PAO provides major deformity correction in Perthes-like hip deformities with associated acetabular dysplasia. Early clinical results suggest this technique is safe and effective. Long-term studies are needed to determine if improved long-term outcomes are associated with comprehensive deformity correction.

Level of Evidence

Level IV, therapeutic study.     

Paraffin Granulomata, ��Witch's Chin,�� and Nasal Deformities: Excision and Reconstruction with Reduction Chinplasty and Open Rhinotomy Resection

A 57-year-old Filipino woman had paraffin materials placed in her nose, chin, and cheeks approximately 15 years prior to consultation. Progressive enlargement of the chin had occurred, simulating a witch''s chin deformity, with a lesser degree of the distal nose and columellar area. Restoration of a relatively normal chin contour was accomplished by using tumescent bi-level anesthesia, mobilizing the protuberant tissues, hemi-ressecting the excess skin, and sculpting the subjacent tissue to an appropriate degree. The nose was then entered at the columellar junction with the upper lip, an open rhinotomy was accomplished, the supra-cartilaginous fibrous tissue was serially ressected to reform the profile, the cartilage was replaced to narrow the nasal configuration, and the nose structure was then replaced. Cosmetic improvement was significant.Contour defects of the face or skin, such as scars from acne, accidents, or reconstructive and cosmetic problems, may be treated by soft-tissue correction. Facial augmentation has been performed by using various materials, including organic substances, such as ivory, liquid paraffin, autologous fat, and coral. Inorganic substances, such as liquid silicone gel, injectable bovine collagen, and gelatin matrix implants, have likewise been used.¹Paraffinoma is defined as a tumefaction, usually a granuloma, caused by the prosthetic or therapeutic injection of paraffin. Parrafin oil, discovered in 1830, is a purified hydrocarbon from petroleum that has been used in the past as an augmentation material in various parts of the human body for restoration of body defects or aesthetic body contouring.² Paraffin injection was regarded as a simple and effective method of improving body contour. It was widely used in breast augmentation until the long-term complication of paraffinoma was recognized.³This procedure requires an undetermined number of repeated injections, which may lead to migration of foreign materials and host immune response. Paraffinoma in the breast can present as a painless breast mass; a destructive ulcer simulating breast carcinoma; a painful, hard mass clinically resembling cancer; or a hard mass with ulceration or sinus formation, usually associated with lymphadenopathy.^3–6 This makes it difficult to correctly diagnose and provide suitable treatment.Some practitioners, especially nonsurgeons and nonphysicians, use liquid injectable materials, such as liquid silicone or paraffin, to perform noselift and chin augmentation procedures. Klein et al⁷ reported scalp paraffinomas, which occurred 35 to 42 years after injection of paraffin for treatment of baldness. These procedures are considered unacceptable in dermatology, dermatological surgery, and cosmetic surgery because of the unstable nature of these materials. These injectable substances migrate to other parts of the face and tumor-like lesions develop after several months or even years. These tumors are known as siliconoma when liquid silicone is used or paraffinoma when paraffin is used.¹These tumors are very difficult to remove, even in the hands of a competent surgeon. The injected material eventually mixes with the tissue, which leads to disfigurement of the face. Long-term follow up is advised to determine the possibility of malignant degeneration after the use of these injectable substances.On the other hand, unabsorbable fatty material used for nasal packing may provoke an inflammatory reaction (variously termed as oleogranuloma, lipogranuloma, paraffinoma, oil granuloma, sclerosing lipogranulomatosis, and myospherulosis). A computed tomography (CT) scan excludes other causes for the deformity. Surgical excision of the tissue is indicated with an appropriate warning of possible recurrence.On CT scan of the face, paraffinoma appears as an ill-defined infiltration in the buccal fat pad and the subcutaneous fat with multiple punctate calcifications (Figure 1). When calcifications associated with soft tissue infiltration are incidentally noticed on CT, particularly bilaterally, the diagnosis of foreign body granulomas secondary to cosmetic cheek augmentation is highly possible and an appropriate review of the medical history is highly recommended.Open in a separate windowOpen in a separate windowFigures 1A and 1BA 54-year-old asymptomatic woman with history of paraffin injection 30 years earlier. Contrast-enhanced computed tomography scans show low density oil droplets with nodular and curvilinear calcifications in the subcutaneous fat layer of bilateral cheeks (large arrows) and nose (small arrow and arrowhead, B). Note other calcifications in bilateral buccal spaces (black arrows, A).¹⁶     

Web文献库模糊优化查询的实现

由于目前大型的Internet结点日益数据库化,同时,传统的数据库系统向Internet平台转移,本文针对一种Web数据库访问模型,提出一种基于Web的数据库模糊优化查询法,以适应网上普通用户信息查询需求,能较有效地改善网上信息查询查准率低的状况.     

基于Web的证券数据库查询系统的实现

探讨了Internet/Intranet上实现数据库发布的几种解决方案的不同特点,详细地阐述了ASP/ADO技术在开发基于Web的证券信息数据库查询系统中的应用,同时给出了不同数据库系统之间进行转换的技术.     

基于B/S模式的Web应用程序的设计

介绍了在Internet/Intranet上设计基于B/S模式的Web应用程序的过程 ,介绍ActiveX与ASP的集成 ,结合一个具体的应用实例 ,给出了基于Browser/Server模式的证券交易数据库查询系统的解决方案 ,实际应用证明 ,基于B/S模式的Web应用程序开发 ,综合了微软COM /DCOM技术和ASP技术 ,使Web应用程序开发效率更高 ,可重用性更好 .     

基于Web of Science数据库对骨质疏松近十年文献计量分析

背景:在全球迈向老年化社会的今天,骨质疏松已成为威胁人类健康、严重影响老年人生活质量的主要疾病之一,骨质疏松症也是医学研究热点之一。目的:初步分析骨质疏松症的研究现状及最新进展,为该领域预防、临床和科学研究提供一定参考。方法:采用Web of Science数据库(简称WoS数据库)核心合集中子库SCI-EXPANDED(SCIE)为研究对象,根据引文分析法统计2009年至2018年近十年间以骨质疏松为主题相关文献,分析WoS数据库核心合集收录骨质疏松领域研究文献状况,包括文献发表出版年、机构、来源出版物、国家地区、研究方向、作者、基金资助等分布情况。结果:通过WoS数据库观察到骨质疏松领域近十年间国内外发表论文共40436篇,相关文献发表在117个国家的2946种期刊中,高产作者中英国的Cooper C发文量最多,与英国的Kanis JA及比利时的Boonen S为重要核心领军人物;科研机构均是大学研究机构,《国际骨质疏松杂志》、《骨与矿物研究杂志》、《骨骼》等业内期刊收录文献最多;研究方向中内分泌代谢与骨质疏松有相当密切关系;基金资助机构主要在国家基金机构或世界百强生物药企;高被引论文多发表在知名度很高的主流及顶尖期刊。结论:近十年我国骨质疏松类论文在该数据库发文量迅猛增长,位居第二位,但被引频次、篇均被引频次和h指数并不高,在论文研究深度与高产作者等方面还存在一定距离,说明总体研究实力还需进一步加强,有较大提升空间。     

基于Web of Science的残胃癌研究可视化及热点分析

背景与目的 残胃癌是一类具有特殊致病因素、临床特征和预后特点的胃恶性肿瘤,发病率呈逐年上升趋势,但在其发生发展机制和手术治疗等方面仍存在较多争议,且当前尚无针对国际残胃癌领域已有的文献进行归纳和可视化分析的研究。本文运用文献计量学的方法对残胃癌领域的英文文献进行可视化分析,梳理其研究现状和热点问题,探讨研究趋势,为该领域未来的研究提供参考依据。方法 在Web of Science核心合集中检索自建库起至2022年12月31日残胃癌领域的文献,应用Excel、VOSviewer和CiteSpace进行发文整体情况分析、社交网络及时序分析、作者共被引分析、关键词共现网络分析和关键词突现情况分析。结果 共纳入400篇英文文献,其中最早的文献发表于1964年。分析时间段内残胃癌领域英文文献多发表在胃肠病学、肿瘤学及手术学专业期刊,年发文量呈波动性缓慢增长,近3年趋于平稳。被引频次最高的文献为O hashi M（2007年）,其次为S asako M（1991年）;发文量前三的国家分别为日本（n=127）、中国（n=42）、韩国（n=32）;荷兰阿姆斯特丹大学是发文最多的机构（n=10）,该机构的Offerhaus GJA在残胃癌领域发文最多（n=10）。共被引频次位列前三的作者分别是Ohashi M（87次）、Sasako M（77次）和Balfour DC（72次）。残胃癌的研究以同一机构内的作者合作为主,除日本国立癌症研究中心同时与国内外的机构均存在密切的合作关系外,国家间、机构间的合作仍相对较少,存在明显的地域性。关键词共现网络显示Surgery（137次）、Distal Gastrectomy（126次）等为该领域的高频关键词。关键词突现情况表明该领域前期主要对良性溃疡性疾病行胃Billroth Ⅱ式切除术后的残胃癌展开研究;中期主要关注幽门螺杆菌感染对残胃的致癌作用、早期残胃癌的内镜切除,以及残胃癌的外科手术淋巴结清扫;近期研究热点为残胃癌的微创治疗、手术并发症、临床病理特征及生存预后,并有望成为未来的研究趋势。结论 残胃癌英文文献总体数量偏少,VOSviewer和CiteSpace能对残胃癌的研究现状进行系统、直观的分析,我国应加强与日本、荷兰等国家的合作,并紧跟当前残胃癌的研究热点,提高学术影响力。     

基于Web of Science护理领域灵性研究热点与前沿分析

目的分析灵性研究在护理领域的态势及研究热点,为我国开展灵性研究提供参考。方法基于Web of Science数据库,主题词="spiritual~*"AND"nurs~*"对1996~2015年护理领域有关灵性研究的文献进行检索,运用CiteSpaceⅡ软件进行知识图谱绘制。结果 1996~2015年护理领域有关灵性研究的文献535篇,美国发文量最多,占43.0%,其次为英国(12.0%)和加拿大(8.0%),中国排名第九,发文量占总体的3.0%。1996~2005年及2006~2015年对比中美两国研究热点发现,美国护理领域对灵性研究较为广泛,且前后十年关注的侧重点有所不同,其中包括多种疾病患者、弱势群体灵性方面的研究及对灵性的认知等多层面、多角度的关注;我国目前对灵性的研究仍处在初步探索阶段,主要关注临终患者(end of life、terminally ill)、护理措施(intervention)及认知(perspective)方面。结论中国护理领域有关灵性研究正处于发展初期,需探索出具有中国特色且适合我国国情的灵性相关研究,提高患者生命质量的同时完善整体护理内涵,使得优质护理服务向纵深方向发展。     

Orthopaedic surgical information on the World Wide Web: fact or fiction?

In response to the creation and popularisation of the Internet as a convenient medium of communication, there has been an explosion of healthcare information readily available to many patients. However, this information is not screened or regulated, and claims may be unsubstantiated and misleading. The aim of this study was to evaluate the nature and quality of orthopaedic surgical information on the World Wide Web (WWW). Three of the most commonly used search engines were assessed for information on three orthopaedic operations: carpal tunnel decompression, lumbar discectomy and anterior cruciate ligament reconstruction. Websites were classified and evaluated for completeness, accuracy, accountability and reference to a reliable source of information. The top (first) 20 relevant websites listed by each search engine for the three search phrases entered were judged, giving a total of 180 addresses. There were 21 triplications and 56 duplications, leaving a residue of 103 addresses for analysis. Health websites totalled 33%; the majority targeted the lay population (67%). Teaching file was the most common type of site (57%). Although 82% contained accurate information, in 67%, this information was incomplete. Of all websites reviewed, 85% were accountable for the information presented, but only 21% made references to reliable sources. The WWW offers easily accessible, patient-orientated orthopaedic surgical information. However, until an organised approach to website control is established, it is important for orthopaedic surgeons to emphasise to their patients that not everything they read is complete or accurate. Publicising sites known to be of high quality will promote safe browsing of the WWW.     

基于Web of Science和CNKI甲状腺癌文献循证可视化及对比分析

目的运用文献计量学的方法分析中、英文数据库中甲状腺癌的研究现状,探索其当前研究热点和未来研究方向。方法分别采用Web of Science和中国知网(CNKI)数据库进行中、英文文献的检索。以"甲状腺癌"为检索词,检索日期自建库至2021-03-20,纳入已发表甲状腺癌的相关文献,采用VOSviewer 1.6.11软件对纳入文献的国家、机构及作者等分布、关键词的聚类及其时序分析,绘制对应的循证可视化图谱。结果分别纳入10 721篇和27 485篇的中、英文文献。结果显示,中、英文文献的年发文量均逐年递增;英文文献在2005年后年发文量的递增趋势更加显著,而中文文献在2009年前后才出现明显递增;在国家和机构方面,英文文献中发文量较大的国家(Top10),绝大多数为欧美及日韩等发达国家,且欧美国家机构间的合作紧密程度较好;然而,中文文献中的发文机构间的合作网络较为局限,呈现出明显的地域性;关键词聚类方面,英文文献的结果提示未来潜在的研究热点为甲状腺癌的分子机制、BRAF突变、外科手术的规范与标准以及甲状腺癌的超声诊断等,而中文文献的聚类相对分散,其聚类主要可归纳为甲状腺癌的诊断、暴露因素及内科治疗和甲状腺癌手术治疗等,且尚未发现甲状腺癌分子机制研究的聚类。结论甲状腺癌的中文文献研究主题明显滞后于英文文献。虽然当前甲状腺癌的研究热点较为分散,但未来应关注甲状腺癌的基础研究、BRAF突变靶向治疗、甲状腺癌的淋巴结清扫和甲状腺癌新型的诊断方法等研究领域。     

基于Web of Science的胃硬癌研究可视化及热点分析

目的 运用文献计量学方法对Web of Science数据库中胃硬癌相关文章进行可视化及热点分析，为未来该领域研究提供参考。方法 检索Web of Science核心合集自建库至2022-12-31的所有胃硬癌相关文献，运用VOSviewer对国家、机构、作者、关键词进行社会网络可视化分析；利用Cite Space绘制关键词突现、作者共被引网络分析图谱。结果 共有354篇英文文献纳入分析，载文量最大的期刊是Cancer Science；日本的发文量及研究成果高影响力在国际上十分突出，其国内的大阪市立大学发文量在所有机构中排名第一；日本作者Yashiro的发文量及共被引频次均居于首位，处于胃硬癌领域核心。该领域研究以同一机构内的作者合作为主，不同机构间、国家间合作较少。研究热点早期为胃硬癌的机制研究，中期为诊断和分期，近期为临床治疗与临床研究。结论基于VOSviewer和Cite Space对胃硬癌领域的文章进行分析，外科手术和围手术期药物治疗有望成为未来的研究热点。     

基于Web of Science数据库及共词聚类分析的肠内营养研究热点

目的分析肠内营养研究现状及热点,为该领域的科学研究和临床工作提供参考。方法基于Web of Science数据库,应用HistCite软件对建库至2018年4月肠内营养研究进行文献计量学分析,并应用CiteSpace软件进行共词聚类分析。结果共检索到5 952篇文献,文献量呈持续增长趋势;通过共词聚类分析总结出肠内营养的研究热点包括活跃的克罗恩病、盲插、危险因素、实践途径、术后早期再喂养、肠道管理等。结论肠内营养相关研究处于不断发展壮大阶段,护理人员可从肠内营养不耐受的相关因素、不同喂养途径的个性化护理、肠内营养并发症护理等方面进行研究。     

基于Web of Science数据库的瑞马唑仑文献计量学与可视化分析

目的 通过文献计量学与可视化分析的方法系统探索瑞马唑仑的研究现状,评价其发展趋势和研究热点。方法 检索Web of Science核心数据库发表的有关瑞马唑仑的文献,检索时间为建库至2022年12月。采用CiteSpace 6.1.R6和Excel 2021分析纳入文献的年发文量、发文国家、发文机构、发文期刊、被引频次和关键词等基本概况。结果 共纳入文献194篇,年发文量最多的国家/地区是中国,最多的机构是德国PAION公司;尽管Anesthesia&Analgesia期刊的共被引频次最高,但在Journal of Anesthesia上发表的有关瑞马唑仑应用于临床的安全性和有效性的文献共被引频次最高;关键词聚类和引文突现分析显示,瑞马唑仑临床应用的安全性和有效性、不同应用场景的有效浓度及特殊人群的用药效果是近几年的研究热点。结论 国内外对瑞马唑仑的研究高度重视,但相关研究质量有待提高。瑞马唑仑在特殊人群用药效果、其最适剂量及对患者预后的影响是该领域未来的研究热点。