国人胫骨平台至腓骨小头高度差距的测量及其临床意义

目的测量胫骨平台至腓骨小头高度之间的差距,以免人工膝关节术(TKA)中伤及外侧副韧带。方法随机选取正常成人31例(39膝),其中男16例(20膝),女15例(19膝)。摄膝关节正、侧位X线片。之后在X线片上测量内、外侧胫骨平台到腓骨小头高度之间的距离。结果男性外侧胫骨平台到腓骨小头高度的平均距离为:10.96mm±3.49mm(5.13～16.76mm)。女性外侧胫骨平台到腓骨小头高度的平均距离为:9.21mm±2.26mm(6.74～11.70mm)。结论TKA术前临床医生应该常规测量胫骨平台至腓骨小头高度之间的距离。如果外侧胫骨平台至腓骨小头高度之间的距离小于8mm,进行胫骨近端截骨时需特别慎重,以避免外侧副韧带的损伤。     

Perception of horizontal distances in patients with spatial neglect

Two different models have argued that neglect of contralateral stimuli following brain damage might be associated with either a compressed or an anisometric neural representation of space along the earth-horizontal axis. We tested these models by determining neglect patients’ perception of spatial distances in the horizontal plane. We found no evidence for any compression or expansion or for anisometry along the earth-horizontal axis. The findings argue against a distortion of subjective space along the horizontal axis in patients with neglect, which could account for their failure to orient towards and to explore the contralesional parts of space.     

中老年人视力损害现状及其影响因素分析

目的 了解中国中老年人视力损害现状及影响视力健康的因素。方法 数据来源于中国健康与退休追踪调查数据,应用多水平logistic回归模型分析影响视力损害的个体和省级因素。结果 共纳入18 439名研究对象,平均年龄为60.3±9.8岁。我国中老年人远视力和近视力损害的患病率分别为19.0%和18.8%。多水平logistic模型结果显示远视力损害的危险因素包括高年龄（50~59岁:OR=1.37,60~69岁:OR=1.74,≥70岁:OR=2.08）、女性（OR=1.35）、农村居住地（OR=1.15）、多病共存（OR=1.85）、高文盲率（中文盲率地区:OR=1.09,高文盲率地区:OR=1.33）和低人均国内生产总值（GDP）（中等收入地区:OR=1.08,低收入地区:OR=1.04）（P均<0.05）;近视力损害的危险因素包括高年龄（50~59岁:OR=1.46）、女性（OR=1.39）、农村居住地（OR=1.39）、多病共存（OR=1.72）、高文盲率（中文盲率地区:OR=1.09,高文盲率地区:OR=1.34）和低人均GDP（中等收入地区:OR=1.32,低收入地区:OR=1.25）（P均<0.05）。高教育水平是远视力损害（小学及初中水平:OR=0.72,高中及以上水平:OR=0.49）和近视力损害（高中及以上水平:OR=0.75）的保护因素（P均<0.001）。结论 远视力损害和近视力损害在我国中老年人中很常见,应针对其危险因素制定防治策略。     

Congreso virtual de dermatología realizado a través de Telegram® durante el confinamiento de la COVID-19: organización y evaluación

IntroductionThe COVID-19 pandemic outbreak introduced dramatic changes in all our lives, daily practice, and medical conferences. In search of a tool to spread dermatologic knowledge during confinement, an online medical meeting was held on April 25th to 26th, 2020. In this study, we aimed to assess the characteristics, opinion and satisfaction of the attendees to a free-of-charge online congress. Secondarily, we intended to explain how this meeting was prepared.Material and MethodsOnline survey administered to the attendees to an online congress organised via the Telegram® Messenger App. Its organisation and planning, which needed no financial support and was done by volunteer organisers, moderators and speakers, is described step by step.ResultsThe satisfaction of both speakers and attendees was very high. All participants considered that this format had a great present and future, and most of them rated it as superior to regular face-to-face meetings. Female gender and predominantly private practice favoured this opinion.DiscussionThe COVID-19 pandemic has forced the cancellation of most scientific gatherings. This has been seen by some authors as an excellent opportunity, encouraging medical societies and organisations to lead the change to virtual meetings. Although confinement did not allow real contact, our online meeting showed it was possible to ensure interaction and participation between attendees, moderators and speakers. Dermatologists enjoyed some dermatologic science, even despite the extraordinary circumstances disrupting their daily clinical practice. Most of them felt they were participating in something new and compelling that many felt superior to traditional meetings.     

A morphometric analysis of developmental instability in children born with unilateral cleft lip and palate

Unilateral cleft lip and palate (UCLP) is a congenital deformity that occurs due to inadequate merging of the nasal and maxillary prominences during fetal development. Randomly distributed bilateral asymmetries known as fluctuating asymmetry (FA) occur in normally symmetric organisms when evolved mechanisms of developmental stability or equilibrium are disturbed by genetic, environmental, or unknown factors. Here, we hypothesize that facial skeleton FA will be increased in a sample of individuals born with UCLP (n = 24) relative to sex‐ and age‐matched controls (n = 24). To test this hypothesis, 23 anatomical landmarks were measured on individual anonymized cone‐beam computerized tomography (CBCT) images in children and adolescents (7–17 years). For each individual, 81 pairs of linear distances were used to estimate FAs across the face. To explore sample variation and statistical differences, a principal components analysis and Euclidean Distance Matrix Analysis multivariate bootstrap approach were carried out. Samples show some separation in multivariate space with 44.44% of FA differences being significantly different. The magnitude of FA was larger in the UCLP sample for every significant measurement. The magnitude of significant FA is highest near regions derived from the maxillary and nasal prominences, such as the nasal aperture. These results are useful for medical and dental practitioners when developing treatment options for children and adolescents with UCLP. Clin. Anat. 32:206–211, 2019. © 2018 Wiley Periodicals, Inc.     

Speeding Up Learning: Accelerated Distance Learning in Rehabilitation Education

Distance learning in higher education involves a continuum of technologies ranging from teleconferencing to video streaming. The United States is approaching a crisis in personnel shortages in rehabilitation counseling and education. Because of these shortages, higher education is called upon to produce counselors in an abbreviated period of time. Thus, distance learning is recognized as an integral part of education, especially for adult learners. This article provides an overview and discussion of the relevance of distance and accelerated learning in rehabilitation and higher education.     

中医药院校现代远程教育探索研究

本文以北京中医药大学远程教育为例,分析了其办学现状及办学中遇到的问题,探讨了未来中医药院校现代远程教育的发展路径。该研究为其他中医药院校或其他类型院校开办远程教育提供了借鉴和经验参考,也为进一步提高远程教育的办学质量和社会影响力、完善现代中医药人才培养体系、提升中医药人才培养质量奠定了基础。     

Significance of hip rotation on measurement of 'Tip Apex Distance' during fixation of extracapsular proximal femoral fractures

The Tip Apex Distance (TAD) is defined as the sum of the distance, in millimetres, from the tip of the lag screw to the apex of the femoral head, as measured on an antero-posterior radiograph and lateral radiograph, after correction has been made for magnification. The relationship between the degree of rotation of the hip joint and its implication on measuring TAD during fixation of a proximal femoral fracture was studied. This relationship has not been previously explored in the English literature. This study involved radiographs of a lag screw placed in a synthetic femur specimen taken in neutral and varying degrees of rotation and adduction/abduction. The lag screw was placed anteriorly in the femoral head. Measurements were taken for each radiograph after correction for magnification. RESULTS: Statistical analysis between measurements showed statistically significant differences (P<0.05) of TAD in AP and lateral (abduction and adduction) views. A graph to show the relationship between hip rotation and TAD was conducted and demonstrates a linear correlation. CONCLUSION: If an anteriorly placed hip screw is not seen to be breaching the articular surface on a view taken in internal rotation, the screw is definitely not in the joint. Beware of a hip screw appearing very close to the joint surface on a view taken in external rotation or abduction as it could be within the joint. The converse may apply to a posteriorly placed screw.