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Objective:To compare the clinical effectiveness between arthroscopic hollow screws combined with a suture anchor, hollow screws and proximal humerus internal locking system (PHILOS) in the treatment of split-type fractures of humeral greater tuberosity.Methods:A retrospective study was conducted to analyze the 54 patients with split-type fracture of humeral greater tuberosity who had been admitted to Department of Joint Surgery, Hospital of Traditional Chinese Medicine, Affiliated to Southwest Medical University from May 2015 to August 2020. There were 17 males and 37 females with an age of (58.4±12.1) years. According to different treatment methods, they were divided into 3 groups. Group A of 18 cases was treated with arthroscopic hollow screws combined with a suture anchor, group B of 18 cases with hollow screws, and group C of 18 cases with PHILOS. The length of surgical incision, and range of shoulder motion, visual analogue scale (VAS), and American Shoulder and Elbow Surgeons (ASES) score at the last follow-up were recorded and compared between the 3 groups.Results:There was no statistically significant difference in the preoperative general information between the 3 groups, indicating the 3 groups were comparable ( P>0.05). The surgical incision in group A [(0.7±0.1) cm] was the shortest, followed by (5.0±1.4) cm in group B, and (12.8±2.1) cm in group C, showing statistically significant differences in pairwise comparison ( P<0.05). In the 3 groups at the last follow-up, respectively, the shoulder forward flexion was 159.7°±13.4°, 154.9°±16.2°, and 160.5°±12.9°, and the shoulder abduction 149.6°±11.3°, 142.4°±12.0°, and 145.1°±10.4°, showing no statistically significant difference among the 3 groups ( P>0.05); the external rotation was 41.1°±8.1°, 38.1°±7.8° and 43.7°±6.2°, showing a statistically significant difference between groups B and C ( P<0.05); the dorsal extension was T 12 (L 5 to T 6), T 12 (L 5 to T 7), and T 12 (L 3 to T 6), showing no statistically significant difference among the 3 groups ( P>0.05). There was no statistically significant difference among the 3 groups in the VAS score or ASES score at the last follow-up ( P>0.05). Respectively, there were 2, 6, and 4 patients in groups A, B and C who developed complications, showing statistically significant differences between the 3 groups ( P<0.05). Conclusions:In the treatment of split fractures of humeral greater tuberosity, arthroscopic hollow screws combined with a suture anchor, hollow screws and PHILOS can all relieve pain and restore joint function of the shoulder. However, arthroscopic hollow screws combined with a suture anchor are the most recommendable due to their advantages in minimally invasiveness and reduction in complications.
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Objective:To survey the demands of tobacco control service among male smoking patients in primary health care settings in Shanghai.Methods:Eight community health service centers in Shanghai were selected through stratified cluster sampling method. A total of 1 458 male patients, who visited their doctors in community health centers in January 2017, completed the questionnaire and were eligible for our study. The contents of questionnaire included demographic information, smoking history, knowledge of tobacco smoking, attitudes toward tobacco control; and the questions regarding smoking cessation service were only for the smokers.Results:Of the 1 458 male patients, there were 679 current smokers (46.6%, 679/1 458), among whom 358 (52.7%, 358/679) intended to quit. The demand rate for the knowledge regarding tobacco and health, smoking cessation plan, overcoming barriers were 58.9% (211/358), 56.4% (202/358) and 53.1%(190/358), respectfully. The rate of demand for smoking cessation hotline was 38.5% (138/358). Those who were under 45 years of age, retirees, suffering from chronic disease (s), having knowledge of tobacco, having knowledge of smoking cessation pathway (s), smoking cessation recommendation from medical staff were more willing to accept tobacco control services.Conclusions:The demand for tobacco control services and utilization rate are relatively low among male smoking patients in primary health care settings in Shanghai. Based on the results acquired from the survey the appropriate measures should be taken.
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Objective@#To survey the demands of tobacco control service among male smoking patients in primary health care settings in Shanghai.@*Methods@#Eight community health service centers in Shanghai were selected through stratified cluster sampling method. A total of 1 458 male patients, who visited their doctors in community health centers in January 2017, completed the questionnaire and were eligible for our study. The contents of questionnaire included demographic information, smoking history, knowledge of tobacco smoking, attitudes toward tobacco control; and the questions regarding smoking cessation service were only for the smokers.@*Results@#Of the 1 458 male patients, there were 679 current smokers (46.6%, 679/1 458), among whom 358 (52.7%, 358/679) intended to quit. The demand rate for the knowledge regarding tobacco and health, smoking cessation plan, overcoming barriers were 58.9% (211/358), 56.4% (202/358) and 53.1%(190/358), respectfully. The rate of demand for smoking cessation hotline was 38.5% (138/358). Those who were under 45 years of age, retirees, suffering from chronic disease (s), having knowledge of tobacco, having knowledge of smoking cessation pathway (s), smoking cessation recommendation from medical staff were more willing to accept tobacco control services.@*Conclusions@#The demand for tobacco control services and utilization rate are relatively low among male smoking patients in primary health care settings in Shanghai. Based on the results acquired from the survey the appropriate measures should be taken.
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Objective To survey on the smoking status among people with disabilities in Shanghai Jing′an District.Methods A cross-sectional questionnaire survey on smoking status among people with disabilities was conducted from July to December 2015 in 5 communities of Shanghai Jing′an District. Results Total 1 815 valid questionnaires were collected.Among all participants,278 were smokers with an overall smoking rate of 15.3%(278/1 815); the smoking rate in males was 28.1%(265/944)and in females was 1.5%(13/871).The disables people aged 45 -60 years had the highest smoking rate (23.4%,141/602).The nicotine dependence rate in regular smokers accounted for 74.6%(182/244). The nicotine dependence was mainly mild to moderate, and the average of Fagerstrom Test of Nicotine Dependence(FTND)score was 3.75 ±1.97.Most participants(90.8%,238/262)were aware of the harm of smoking to health,but the awareness rate of health hazards of second-hand smoke was only 59.5%(156/262).The awareness rates of tobacco-related diseases were all lower than 70%.The rate of quitting was 33.5%(93/278),but only 17.2%(16/93)succeeded;66.0%(173/262)of the smokers did not intend to quit,only 15.3%(40/262)started to quit or to reduce the smoking;and 83.6%(219/262)of current smokers thought that it was impossible to quit smoking.Conclusion The smoking rate in people with disabilities is lower than that in the general population,the awareness of the harm of second-hand smoke is low and there is lack of knowledge of tobacco related diseases;the intend of quitting is low but the success rate of smoking cessation is high among people with disabilities in Shanghai Jing ′an District.
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Objective This study was to analyze the early and long-term effect of completion pneumonectomy.Methods Retrospective analysis was made on the patients who underwent completion pneummonectomy in Shanghai Chest Hospital.Results There were totally 56 cases patients underwent completion pneumonectomy during January 2003 to July 2013.Among them,45 patients received CCP,and other 11 patients received RCP.CCP refers to the complete removal of lung tissue remaining after an initial ipsilateral partial pulmonary resection.RCP refers to the complete removal of residual lung due to the severe complications after pneumonectomy.The mortality and morbidity rate of CCP were 4.4％ and 33.3％ respectively.In the case of CCP,the incidence of benign lesions is significantly higher than the incidence of malignant tumor(80.0％ vs 27.5％,P =0.04).The mortality and morbidity rate of RCP were 27.3％ and 90.9％ respectively.In the case of RCP,higher postoperative mortality often occurs in aged patients (P =0.046) and patients with preoperatie mechanical ventilation (P =0.03).Overall five-year survival rate for patients with benign lesions was 80％,and for malignant lung cancer patients,the number was 30％.Survival time differs according to the TNM staging(a median of 60.0 months,35.0 months,10.0 months,stage Ⅰ,stage Ⅱ,stage Ⅲ,P ＜0.01),and survival rate was higher when the time interval(between the initial pulmonary resection and the completion pneumonectomy) ＞ 2 years(a median of 60.0 months,18.0 months,P ＜ 0.01).Conclusion Completion pneumonectomy is a high-risk surgery,especially RCP.Advanced age and preoperative mechanical ventilation are associated with higher postoperative mortality rate for RCP.As for CCP,higher postoperative risk exists in patients with benign lesions,but the survival rate is also higher.In patients with malignant lung tumor,survival rate is higher when the time interval (between the initial pulmonary resection and the completion pneumonectomy) ＞2 year.
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BACKGROUND:Anterior cruciate ligament (ACL) injury is a commonly sport-induced knee joint injury that does serious harm to the knee stability. ACL reconstruction is a commonly used treatment method, but researches on 1/2 peroneus longus tendon (PLT) graft are rarely reported. OBJECTIVE: To investigate the clinical outcomes of removing the autologous ipsilateral 1/2 PLT under arthroscopy for ACL reconstruction. METHODS:106 patients with complete ACL rupture in the Affiliated Hospital of Traditional Chinese Medicine, Southwest Medical University from December 2010 to December 2014 were enrolled, and autologous ipsilateral 1/2 PLT was removed under arthroscopy for ACL reconstruction. At baseline, 3, 6 and 12 months postoperatively, the knee stability was evaluated manually through the anterior drawer test, Lachman test, and pivot-shift test, and the knee function was evaluated by Tegner activity scale, Lysholm and International Knee Documentation Committee scores. RESULTS AND CONCLUSION: Postoperative anterior drawer test, Lachman test, and pivot-shift test tests were negative in all patients. In terms of Tegner activity scale, Lysholm and International Knee Documentation Committee scores, there were significant differences at baseline and postoperative 3 months as compared with postoperative 6 months (P 0.05). These results indicate that autologous ipsilateral 1/2 PLT is a good choice for ACL reconstruction under arthroscopy, achieving rapid and satisfactory functional recovery of the knee joint, which is not only minimally invasive and easy to operate, but also exhibits good therapeutic efficacy.
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BACKGROUND: Greater tuberosity of humerus, as the attachment point of rotator cuff, plays a vital role in shoulder.Neer and AO classification for proximal humeral fractures have been accepted extensively. However, the classification for single greater tuberosity fractures of the proximal humerus is little reported, and its fixation method remains controversial.OBJECTIVE: To explore the curative efficacy of the double-row suture anchors under arthroscopy for avulsion-type greater tuberosity fractures (Mutch type Ⅰ) METHODS: Clinical data of 24 patients with avulsion-type greater tuberosity fractures (Mutch type Ⅰ) undergoing double-row suture anchors under arthroscopy were analyzed retrospectively. The displacement distance of the greater tuberosity of humerus was measured on CT before and after fixation. The shoulder joint was evaluated by Constant-Murley Score and the University of California, Los Angeles score at baseline, 1, 3, 6 and 12 months postoperatively. Besides, the visual analogue scale scores were detected at baseline and 12 months postoperatively.RESULTS AND CONCLUSION: (1) Double-row suture anchors effectively improved the displacement of greater tuberosity and rotator cuff injury. (2) The patients accompanied by rotator cuff injury accounted for 79.16%. (3) The Constant-Murley Score and the University of California, Los Angeles scores were significantly improved at each time point (P < 0.05). The visual analogue scale scores after fixation were significantly superior to those before fixation (P < 0.05). (4) These results suggest that the double-row suture anchors under arthroscopy can effectively improve the displacement of greater tuberosity and alleviate the pain. Moreover, it is conductive for early recovery of the shoulder function with little trauma, so it is a good choice for avulsion-type greater tuberosity fractures (Mutch type Ⅰ).
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Notch signaling is an important evolutionarily conserved pathway involving the fate of cells translation. Additional?ly, this pathway also plays an important role in cartilage formation and maintenance of chondrocytes phenotype, regulation of the prolif?eration, maturation and balance of cartilage matrix metabolism. This paper reviews the composition and activation process of notch sig?naling, and its specific role in cartilage formation.
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Objective To assess community health service ability of general practitioners (GPs) with the Standardized General Practitioner Training(SGPT) in Shanghai.Methods One hundred and four GPs receiving SGPT and matched 102 GPs without SGPT were enrolled in this retrospective cohort study from September to November in 2014.Community health service ability,including abilities in basic medical service and public health service were assessed and compared between two groups.Written examination was applied in the public health services ability assessment.Objective structured clinical examination (OSCE) was applied for evaluation of basic medical service abilities.Results The scores of written examination in GPs with SGPT were higher than those without SGPT[(66 ±4) vs.(62 ±7),P ＜0.01].The OSCE scores in GP with SGPT were higher than those without SGPT [(494 ± 78) vs.(448 ± 80),P ＜ 0.01].GPs with SGPT also abtained the higher scores in consultation competence and clinical skills assessment [(245 ± 44) vs.(225 ±40),P＜0.01;(252 ±59) vs.(225 ±61),P ＜0.01].In OSCE,GPs with SGPT got higher score than those without SGPT in 5 stations (medical history collection,doctor-patient communication,basic operation,ECG interpretation,and CPR) (all P ＜ 0.01);however,no significant differences were observed in 3 stations (physical examination,case analysis and X-ray interpretation) between two groups (all P ＞ 0.05).Conclusions GPs with SGPT have better basic medical service and public health service ability.But some aspects of basic medical service ability need to be strengthened in the training and practice.
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Objective To evaluate the clinical capability of young general practitioners (GPs) in communities in Shanghai.Methods A cross-sectional survey on clinical ability of young GPs was adopted from October to December 2014.Total 211 GPs aged (31 ± 2) years (25-35) from 17 districts of Shanghai participated in the study.Written examination and objective structured clinical examination (OSCE) was applied in the evaluation.Results All 211 GPs (63 male and 148 females) completed the assessment.The overall score of the assessment was (602 ± 83) and the pass rate was 62.6％ (132/211).In written examination the average score was (64 ±7) and the pass rate was 72.1％ (152/211).In OSCE,the highest score (80 ± 15) and pass rate (92.9％,196/211) was in CPR skill,followed by communication skill [average score:(76 ± 15) and pass rate:85.8％ (181/211)].The lowest average score was physical examination (47 ± 15) with a pass rate of 26.1％ (55/211),followed by electrocardiogram reading [average score:(84 ±31) and pass rate:39.8％ (84/211)].In basic operation station,the lowest score was using funduscope and gynecologial examination (29.8％ and 45.4％,respectively).Conclusion Young GPs in Shanghai communities basically master clinical skills,but also have some deficiencies,the training in certain skills need to be strengthened.
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Objective To survey on utilization of hospital beds in rural and urban community health centers in Shanghai.Methods The hospital beds utilization was investigated in one rural and one urban community health service centers in Shanghai.The data of hospitalized patients in a selected day were surveyed with self-made questionnaire,including the demographic information of patients,the diseases category,the length of hospital stay,self-care ability of daily life (ADL score),the purpose of hospitalization,and the management after discharge.Results Patients aged over 60 y accounted for 100.0％ (138/138) in urban center and 98.7％ (76/77)in rural center.The three top disease categories were all cardio or cerebrovascular diseases in urban center accounting for 86.9％ (120/138),while those in rural center were hypertension,cerebral infarction and acute/chronic bronchitis (or tumor)accounting for 65.0％ (50/77).The mean length of hospital stay in urban and rural centers were 609.6 d and 253.8 d,respectively (F =2 604.00,P =0.000).Patients with severe dysfunction in urban and rural centers accounted for the 84.0％ (116/138) and 32.5％ (35/77),respectively (x2 =80.911,P=0.000).Patients not willing to be discharged in urban and rural centers accounted for 87.7％(121/138)and57.1％ (44/77),respectively in city and rural centers(P ＜0.05).Conclusions The wards in community health centers mainly serve the elderly patients.There are differences in purpose of hospitalization,length of hospital stay,ADL scores of patients between rural and urban community health centers.
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Transcription repressor ZHX2 is one of the members in ZHX protein family,which exists widely in human tissue and participates in the occurrence and development of various diseases.Researches show that ZHX2 is closely related to the occurrence and development of cancers,such as liver cancer,multiple myeloma,gastric cancer and colorectal cancer,which has the potential value of tumor treatment.
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Objective To investigate complications and mortality of primary reamed intramedullary nailing for femoral shaft fractures in patients a ssociated with thoracic injuries. Methods A retrospective a nalysis of trauma data was performed and the case selection based on the followi ng criteria: (1) patient age of 17-65 years, (2) patients with multiple injury ( ISS≥16) as well as complicated thoracic trauma (AIS≥2), (3) hospitalization stay ≥48 hours, (4)no serious pre-existing medical diseases in history, (5) as sociated femoral shaft fractures treated with reamed intramedullary nailing, ext ernal fixation, plate, cast, traction and unreamed intramedullary nailing. The s elected patients were divided into two groups according to the interval from inj ury to operation, ie, those within 24 hours as Group A and beyond 24 hours as Gr oup B. Results During the study period, 96 patients met the criteria for the investigation. There were 57 patients in the Group A and 39 pa tients in the Group B. In two groups, there was significant difference in incide nce of open femoral shaft fractures (53% in the Group A and 31% in the Group B, ? 2=4.496, P
