Intraoperative electrical stimulation promotes the short-term recovery of patients with cubital tunnel syndrome after surgery.

BACKGROUND: This study was designed to investigate whether intraoperative electrical nerve stimulation has effects on the short-term recovery of cubital tunnel syndrome patients after ulnar nerve release. METHODS: Patients diagnosed as cubital tunnel syndrome were selected. At the same time, they received conventional surgery treatment. The patients were divided by a randomized digits table into two groups. The control group underwent conventional surgery, and the electrical stimulation (ES) group underwent intraoperative electrical stimulation. All the patients were tested for sensory and motor functions, grip strength, key pinch strength, motor conductivity velocity (MCV), and maximum compound muscle action potential (CMAP) before operation and 1 month and 6 months after operation. RESULTS: In patients treated with intraoperative ES, the sensory and motor functions and the strength of muscle were significantly improved after 1-month and 6-month follow-up than the control group. After the follow-up, the patients in the ES group had significantly higher grip strength and key pinch strength than the control group. After the follow-up, the patients in the ES group had significantly higher MCV and CMAP than the control group. CONCLUSION: Intraoperative electrical stimulation of nerve muscle can significantly promote the short-term recovery of nerve and muscle functions after the surgery in cubital tunnel syndrome patients.

Associations between Dietary Patterns and Physical Activity with Physical Fitness among Adolescents in Shandong Province, China: A Cross-Sectional Study.

BACKGROUND: The trend of physical fitness (PF) and physical activity (PA) among Chinese adolescents is not optimistic, and unhealthy dietary behaviors are common. PA and dietary patterns (DPs) have been linked to PF in adolescents, but the associations between DPs and PF with PF in Chinese adolescents are rarely discussed. METHODS: A total of 8796 adolescents aged 11-18 were enrolled from Shandong Province, China. The CNSPFS battery was applied to assess PF. PA levels and diet quality were determined using the Physical Activity Questionnaire for Adolescents and the modified Chinese Diet Quality Questionnaire, respectively. This study used factor analysis to identify DPs and linear regression models to investigate the association between PF and related factors. RESULTS: The average PF score of the participants was 75.67. Adolescents who were girls, lived in rural areas and were active in PA performed better on the PF test (p < 0.05). Boys whose fathers were university educated or above had a higher probability of achieving higher PF scores (OR 4.36, 95% CI 1.32-14.36); however, if their mothers were university educated or above, they had a lower probability of achieving higher PF scores (OR 0.22, 95% CI 0.063-0.76). Unhealthy dietary pattern was negatively correlated with cardiorespiratory fitness in boys (OR 0.56, 95% CI 0.31-0.98). The association between unhealthy dietary pattern and girls' BMI became significant after adjustment for PA (p < 0.05). CONCLUSIONS: Girls performed better in PF than boys. Highly educated fathers could contribute to improve the PF performance in boys. There were four DPs among adolescents in Shandong Province, and different DPs may have different effects on PF in boys and girls.

Characteristics of Artificial Intelligence Clinical Trials in the Field of Healthcare: A Cross-Sectional Study on ClinicalTrials.gov.

Artificial intelligence (AI) has driven innovative transformation in healthcare service patterns, despite a lack of understanding of its performance in clinical practice. We conducted a cross-sectional analysis of AI-related trials in healthcare based on ClinicalTrials.gov, intending to investigate the trial characteristics and AI's development status. Additionally, the Neo4j graph database and visualization technology were employed to construct an AI technology application graph, achieving a visual representation and analysis of research hotspots in healthcare AI. A total of 1725 eligible trials that were registered in ClinicalTrials.gov up to 31 March 2022 were included in this study. The number of trial registrations has dramatically grown each year since 2016. However, the AI-related trials had some design drawbacks and problems with poor-quality result reporting. The proportion of trials with prospective and randomized designs was insufficient, and most studies did not report results upon completion. Currently, most healthcare AI application studies are based on data-driven learning algorithms, covering various disease areas and healthcare scenarios. As few studies have publicly reported results on ClinicalTrials.gov, there is not enough evidence to support an assessment of AI's actual performance. The widespread implementation of AI technology in healthcare still faces many challenges and requires more high-quality prospective clinical validation.

Repair of finger pulp defects using a free second toe pulp flap anastomosed with the palmar vein.

PURPOSE: To evaluate the clinical utility of surgical reconstruction of finger pulp defects using a plantar flap derived from the toes, with vascular anastomosis of the toe-finger artery and the plantar-palmar vein of the finger. METHODS: Between April 2018 and November 2020, 29 patients with finger pulp defects underwent treatment via the transplantation of pulp tissue from the second toe, with the plantar vein of the toe and the palmar vein of the finger being anastomosed during this procedure. In addition, an anastomosis of the toe and finger artery and nerve was conducted, with a flap size of 1.0 cm * 0.8 cm-2.3 cm * 4.0 cm being used for such repair. Donor tissue sites were closed without introducing deformities or other complications. RESULTS: In all patients in the present study, flap tissues survived and did not exhibit evidence of vascular crisis over a mean 16.8-month follow-up period (range 8-24 months). After successful skin flap grafting, they exhibited good elasticity and a soft texture. At three months post-surgery, some patients reported partial recovery of touch sensation in the transplanted tissue, while pain recovery was evident in some patients at 4-6 months post-surgery. No deformities or other complications were observed at the donor site, and the ability of patients to walk normally was not impaired. CONCLUSION: The anastomosis of toe plantar flaps with the palmar vein can facilitate the repair of finger pulp injuries without the need to dissect the dorsal vein of the toe, allowing for the suturing of donor tissue sites without causing any deformities or other complications. This surgical approach can easily be conducted with satisfactory clinical outcomes.

Mental Health Problems and Associated Factors among High School Students in Shandong Province of China: A Cross-Sectional Study.

Background: Although many studies have analyzed the mental health problems (MHP) of Chinese adolescents, the associations of Chinese high school students' MHP with personal and family circumstances, parents' educational level, physical activity, and school adaptation are rarely discussed. Methods: The participants were 9398 students who were randomly recruited from 30 high schools in Shandong, China. Self-reported questionnaires were used to collect data. Multivariate logistic regression models were used to investigate associations between MHP and related factors. Results: The positive rate of MHP among high school students was 27.0%. Female, intimate friends of the opposite sex, poor family economic status, father's educational level of primary school or below, low social competence, and high antisocial behavior were significantly associated with higher odds of having MHP (p < 0.05). Students' self-reported odds of having obsessive−compulsive disorder, interpersonal sensitivity, and depression were inversely related to their mother's educational level. Compared with students who did not exercise, students who engaged in more than 30 min of physical activity 5−6 times per week had 60% lower self-reported odds of depression. Conclusions: We recommend strengthening the prevention, early detection, and treatment of MHP in high school students, especially those whose parents have low educational attainment, inactivity, and high disruptive behaviors.

Clinical Application of Restrictive Brace Combined with Psychological Intervention after Replantation of Severed Fingers in Children.

Objective: After replantation of severed fingers in infants, the utility model patent upper limb restrictive brace-assisted bed rest braking, combined with psychological intervention, can alleviate children's anxiety, so as to reduce the occurrence of vascular crisis. Methods: The study period was from April 2015 to July 2018. In this paper, 30 children with finger injuries in hand surgery in the CIS electronic medical record system of Cangzhou Integrated Traditional Chinese and Western Medicine Hospital were selected as the research objects. Replantation was performed in 30 infants with severed fingers. Among them, 15 cases were applied with the method of aircraft chest arm gypsum splint combined with sedative drug braking and the utility model patented product upper limb restrictive brace fixation-assisted bed rest braking, and the method of psychological intervention was applied at the same time. Results: Among the 15 fingers in the control group, 6 had vascular crisis and 1 in the experimental group. The incidence of vascular crisis in the experimental group was lower, and the difference between the two groups was statistically significant (P < 0.05). The patients were followed up for 9~18 months, with an average of 9.72 ± 1.07 months. In the control group, 15 cases of severed fingers survived, and there were 13 cases of replantation finger necrosis in 2 cases of intractable arterial crisis. In the experimental group, 14 cases of severed fingers survived in 15 cases and there was 1 case of replanted finger necrosis in intractable arterial crisis after operation. There was no significant difference in the survival rate between the two groups (P > 0.05). In addition, the replanted finger function was evaluated. In the control group, 9 cases were excellent, 4 cases were good, and 1 case was fair. In the experimental group, 14 cases were excellent, 1 case was good, and 0 case was fair. The functional evaluation of the experimental group was better than that of the control group, and the difference between the two groups was statistically significant (P < 0.05). Conclusion: For infants after replantation of severed fingers, the application of the utility model patented product upper limb restrictive brace can effectively make up for the insufficient fixation of aircraft chest arm gypsum splint, reduce the occurrence of vascular crisis, and assist children in bed. In addition, the application of psychological intervention can reduce children's postoperative crying and is conducive to children's postoperative recovery.

Ulnar Groove Plasty Guided by a 3D Printing Technique for Moderate to Severe Cubital Tunnel Syndrome Caused by Elbow Osteoarthritis.

BACKGROUND The purpose of this study was to explore the feasibility of ulnar groove plasty guided by a three-dimensional (3D) printing technique for treatment of moderate to severe cubital tunnel syndrome (CuTS) caused by elbow osteoarthritis. MATERIAL AND METHODS Patients with moderate to severe CuTS secondary to osteoarthritis of the elbow were enrolled in our hospital from April 2015 to March 2018. Based on a previously proposed "elbow canal index", a 1: 1 model of the elbow joint was printed using CT image data collected preoperatively. After computer-aided measurement, the standard for enlargement of the ulnar nerve groove was calculated and a personalized "trial model" was created by 3D reconstruction. After intraoperative exposure of the ulnar nerve sulcus, the proliferative osteoid was burred with a grinding drill, and the cubital enlargement was verified by the trial model. The ulnar nerve was decompressed and reincorporated into the enlarged cubital canal, and the Osborne ligament was zig-zag elongated and reconstructed. RESULTS None of the patients reported experiencing medial elbow instability, medial elbow pain, ulnar nerve subluxation, flexor-pronator weakness, or incision infection. There was significant improvement of the motor nerve conduction velocity, sensory nerve conduction velocity, two-point discrimination of the little finger, grip strength, pinch strength of the thumb and index finger, VAS score, and DASH score in this study (P<0.001). CONCLUSIONS Ulnar groove plasty guided by a 3D printing technique may be another effective treatment of moderate to severe CuTS caused by elbow osteoarthritis.

Endoscopic Surgery for Delayed Wound Healing After Achilles Tendon Suture Repair: A Report of Three Cases.

BACKGROUND: Delayed wound healing is a potention complication after Achilles tendon suture repair and occurs for various reasons. The conventional treatment for delayed wound healing is open surgery, but patients face long recovery times and postoperative care is difficult. CASE PRESENTATION: This report presents three patients who were seen at our institute from April 2008 to October 2017 due to long-term non-healing wounds after surgery. All three patients had undergone surgery at least 2 months previously. We performed endoscopic surgery on these patients. After the operation, patients received less antibiotics and simpler care than would be required for conventional open surgery. There is no need to keep the wound open after the operation or perform wound cleaning for multiple times at the same time, which can reduce healing time. At the last follow up, all postoperative scores among the patients were significantly improved compared to before surgery. The Achilles tendon total rupture scores were excellent and the American Orthopedic Foot and Ankle Society scores were satisfactory, indicating improvements in Achilles tendon function and movement in patients after surgery. CONCLUSION: Our case reports demonstrate that arthroscopic treatment for delayed wound healing after Achilles tendon suture repair is satisfactory and reliable; frequent opening of the wound for cleaning is not required after the operation, thus reducing the healing time.

The US Public's Perception of the Threat of COVID-19 During the Rapid Spread of the COVID-19 Outbreak: Cross-Sectional Survey Study.

BACKGROUND: The rapid spread of the COVID-19 pandemic in the United States has made people uncertain about their perceptions of the threat of COVID-19 and COVID-19 response measures. To mount an effective response to this epidemic, it is necessary to understand the public's perceptions, behaviors, and attitudes. OBJECTIVE: We aimed to test the hypothesis that people's perceptions of the threat of COVID-19 influence their attitudes and behaviors. METHODS: This study used an open dataset of web-based questionnaires about COVID-19. The questionnaires were provided by Nexoid United Kingdom. We selected the results of a questionnaire on COVID-19-related behaviors, attitudes, and perceptions among the US public. The questionnaire was conducted from March 29 to April 20, 2020. A total of 24,547 people who lived in the United States took part in the survey. RESULTS: In this study, the average self-assessed probability of contracting COVID-19 was 33.2%, and 49.9% (12,244/24,547) of the respondents thought that their chances of contracting COVID-19 were less than 30%. The self-assessed probability of contracting COVID-19 among women was 1.35 times that of males. A 5% increase in perceived infection risk was significantly associated with being 1.02 times (OR 1.02, 95% CI 1.02-1.02; P<.001) more likely to report having close contact with >10 people, and being 1.01 times (OR 1.01, 95% CI 1.01-1.01; P<.001) more likely to report that cohabitants disagreed with taking steps to reduce the risk of contracting COVID-19. However, there was no significant association between participants who lived with more than 5 cohabitants or less than 5 cohabitants (P=.85). Generally, participants who lived in states with 1001-10,000 COVID-19 cases, were aged 20-40 years, were obese, smoked, drank alcohol, never used drugs, and had no underlying medical conditions were more likely to be in close contact with >10 people. Most participants (21,017/24,547, 85.6%) agreed with washing their hands and maintaining social distancing, but only 20.2% (4958/24,547) of participants often wore masks. Additionally, male participants and participants aged <20 years typically disagreed with washing their hands, maintaining social distancing, and wearing masks. CONCLUSIONS: This survey is the first attempt to describe the determinants of the US public's perception of the threat of COVID-19 on a large scale. The self-assessed probability of contracting COVID-19 differed significantly based on the respondents' genders, states of residence, ages, body mass indices, smoking habits, alcohol consumption habits, drug use habits, underlying medical conditions, environments, and behaviors. These findings can be used as references by public health policy makers and health care workers who want to identify populations that need to be educated on COVID-19 prevention and health.

Construction of a Digestive System Tumor Knowledge Graph Based on Chinese Electronic Medical Records: Development and Usability Study.

BACKGROUND: With the increasing incidences and mortality of digestive system tumor diseases in China, ways to use clinical experience data in Chinese electronic medical records (CEMRs) to determine potentially effective relationships between diagnosis and treatment have become a priority. As an important part of artificial intelligence, a knowledge graph is a powerful tool for information processing and knowledge organization that provides an ideal means to solve this problem. OBJECTIVE: This study aimed to construct a semantic-driven digestive system tumor knowledge graph (DSTKG) to represent the knowledge in CEMRs with fine granularity and semantics. METHODS: This paper focuses on the knowledge graph schema and semantic relationships that were the main challenges for constructing a Chinese tumor knowledge graph. The DSTKG was developed through a multistep procedure. As an initial step, a complete DSTKG construction framework based on CEMRs was proposed. Then, this research built a knowledge graph schema containing 7 classes and 16 kinds of semantic relationships and accomplished the DSTKG by knowledge extraction, named entity linking, and drawing the knowledge graph. Finally, the quality of the DSTKG was evaluated from 3 aspects: data layer, schema layer, and application layer. RESULTS: Experts agreed that the DSTKG was good overall (mean score 4.20). Especially for the aspects of "rationality of schema structure," "scalability," and "readability of results," the DSTKG performed well, with scores of 4.72, 4.67, and 4.69, respectively, which were much higher than the average. However, the small amount of data in the DSTKG negatively affected its "practicability" score. Compared with other Chinese tumor knowledge graphs, the DSTKG can represent more granular entities, properties, and semantic relationships. In addition, the DSTKG was flexible, allowing personalized customization to meet the designer's focus on specific interests in the digestive system tumor. CONCLUSIONS: We constructed a granular semantic DSTKG. It could provide guidance for the construction of a tumor knowledge graph and provide a preliminary step for the intelligent application of knowledge graphs based on CEMRs. Additional data sources and stronger research on assertion classification are needed to gain insight into the DSTKG's potential.

[Investigation of replantation of thumb rotation avulsion injury].

OBJECTIVE: To investigate replantation methods and clinical outcomes of thumb rotation avulsion injury,and to evaluate the advantages and disadvantages of each procedure. METHODS: From Feburary 2009 to March 2012, 21 thumbs suffered from rotation avulsion injuries and replanted by different methods, including 16 males and 5 females with an average age of 32 years old ranging from 16 to 45 years old. Diffierent methods were chosen according to the traumatic condition. And the survival condition and function of the thumbs after replantation were observed and evaluated. RESULTS: Among them, 19 replanted figers were survival, 2 cases failed. The mean follow-up period was 8 months (ranged from 3 to 14 months). According to the criteria for function assement of amputated finger issued by the Branch of Hand Surgery of Chinese Medicine Association, the results were excellent in 13 cases, good in 5, and poor in 1. CONCLUSION: According to the traumatic condition to choose various approach in replantation of thumb with rotation avulsion, leading to a higher success rate, and provide the patients with a more aesthetic appearance and satisfied function.

[Abdominal random single pedicled flap of three leaves for the treatment of multiple finger skin defects].

OBJECTIVE: To discuss the effect of abdominal random single pedicled flap of three leaves for skin defects construction of the ends of several fingers. METHODS: From March 2005 to October 2010, 30 patients (90 fingers) with skin defects of the ends of several fingers were treated by abdominal random single pedicled flap of three leaves, including 20 males (60 fingers) and 10 females (30 fingers) with an average age of 36 years old ranging from 15 to 56 years. The degloving injury or transverse defect of distal phalanx were treated with abdominal random single pedicled flap of three leaves. Postoperative survival of skin flap, flap shape, complications were observed, and the static two-point discrimination of flap were determined. RESULTS: All patients were followed up for 12.6 mouths in average. All the flaps survived. The color, texture and shape of the flaps were good. The static two-point discrimination was 5 to 10 mm. The function of the hands recovered satisfactory. CONCLUSION: The method of abdominal random single pedicled flap of three leaves has the advantages of simple, safe and less trauma for the donor site. The effect is satisfatory for skin defects construction of the ends of several fingers.