[Effects of functional training combined with self-made hand flexing training band in treatment of scar contracture after burn injury of dorsal hand].

Objective: To observe the effects of functional training combined with self-made hand flexing training band in treatment of scar contracture after burn injury of dorsal hand. Methods: Forty-six patients with scar contracture after deep partial-thickness or full-thickness burn injury of dorsal hand hospitalized in our department from March 2013 to February 2015 were divided into routine training group (RT, n=18) and comprehensive training group (CT, n=28) according to their willingness. Two weeks after the wounds were healed, patients in group RT were treated with functional training of hands and self-made pressure gloves, while patients in group CT were treated with self-made hand flexing training band (consisting of nylon strap, flexing band, and velcro) on the basis of those in group RT. All patients were treated for 3 months. Before and after treatment, scar condition of affected hands was assessed with Vancouver Scar Scale (VSS). The range of motion of joints of affected hands was measured by Total Active Movement (TAM) Scale. The function of affected hands was evaluated by Carroll Upper Extremity Function Test. Data were processed with t test, chi-square test, and Mann-Whitney U test. Results: (1) The score of VSS in patients of group RT was (10.0±1.9) points before treatment and (4.4±1.4) points after treatment, with the improved score of (5.6±1.0) points. The score of VSS in patients of group CT was (10.5±1.8) points before treatment and (4.6±1.4) points after treatment, with the improved score of (5.9±1.2) points. There was no statistically significant difference in the improved score of patients between the two groups (t=0.834, P>0.05). The score of VSS in patients of groups RT and CT after treatment was significantly lower than that before treatment (with t values respectively 14.014 and 10.003, P values below 0.01). (2) Before treatment, the ratios of excellent and good results according to TAM were 2/9 in patients of group RT and 3/14 in group CT, with no statistical differences between them (χ(2)=2.140, P>0.05). After treatment, the ratio of excellent and good results according to TAM in patients of group CT (6/7) was higher than that in group RT (5/9, χ(2)=0.023, P=0.038). The ratios of excellent and good results according to TAM in patients of groups RT and CT after treatment were significantly higher than those before treatment (with Z values respectively -2.023 and -4.780, P values below 0.05). (3) The improved score of hand function in patients of group CT was (26±12) points, which was higher than (15±7) points in group RT (t=3.278, P=0.002). The score of hand function in patients of groups RT and CT after treatment was significantly higher than that before treatment (with t values respectively 2.628 and 6.125, P values below 0.05). There were no significant differences in grades of hand function of patients between the two groups before treatment (Z=-0.286, P>0.05). After treatment, the grade of hand function in patients of group CT was higher than that in group RT(Z=-1.993, P=0.046). The grades of hand function in patients of groups RT and CT after treatment were significantly higher than those before treatment (with Z values respectively -2.717 and -4.998, P values below 0.01). Conclusions: For patients with scar contracture after burn injury of dorsal hand, early functional training combined with hand flexing training band can improve the range of motion of hand joints and functional recovery of hand, and the result was better than functional training alone.

Serum troponin I concentrations assessed 18-24 hours after coronary artery bypass grafting are significant predictors of early patient prognosis.

OBJECTIVE: Coronary heart disease (CHD) is a frequent medical condition in developed countries and is one of the most serious diseases threatening patients' lives. Perioperative myocardial infarction is the major cause of perioperative cardiac death and cardiac arrest, but is difficult to be precisely identified by observing clinical symptoms or assessing cardiac enzyme levels or by ECG examination. Therefore, assessment of patient prognosis requires reliable predictors. In this regard, we tested the prognostic value of serum troponin I (TnI) concentrations. PATIENTS AND METHODS: 98 patients undergoing elective simple off-pump coronary artery bypass grafting were recruited. Venous blood samples were collected within 3-5 hours, 18-24 hours, and 36-48 hours post-operation, and associations of TnI concentrations with early outcomes measures (duration of assisted ventilation, length of stay in the ICU, length of postoperative stay, administration of antihypotensive medications, use of intra-aortic balloon pump, and ECG abnormalities) were evaluated. Correlations of postoperative TnI concentrations with the outcomes measures were analyzed by using median TnI concentrations as the cut-off value. RESULTS: TnI concentrations assessed within 18-24 hours post-operation showed significant associations with most tested outcome measures (p < 0.05 for four out of five comparisons). Furthermore, after building ROC curves, the highest AUC values (> 0.9) were also observed for TnI1 concentrations assessed within this time frame. The optimal cutoff value for TnI concentration was 1.78 ng/ml. CONCLUSIONS: TnI concentrations assessed within 18-24 hours after elective off-pump coronary artery bypass grafting can effectively predict early patient prognosis.

[Genetic epidemiological investigation of cleft lip and cleft palate].

From July 1, 1985 to June 31, 1987, the birth defect monitoring was carried out in 30 hospitals in Anhui Province. It was found that there were 116 cases of cleft lip (CL) and cleft palate (CP) in 46,811 perinatals. The incidence rate of CL and/or CP was 2.48%. It was higher level both in China and abroad. Among these cases, there were 105 cases (90.52%) with CL +/- CP. The incidence rate of CL and CP related to maternal age, birth order, educated level, resident place, occupation and pregnant season was studied. The frequency of first degree relative was 28.26%. That was about thirteen times higher than the birth population frequency. The incidence rate in the offspring of parental-consanguinity was 9.53% (9/944). This is significantly higher than that of non-consanguineous marriage (P less than 0.001). There were three same sex twins affected by CL +/- CP in the 548 pairs of twins, none of the twins with CL +/- CP had identical one. Only one pair of the female twins was affected by different defects. The heritability was found to be 59.6% and was lower than data in other reports. It suggests that environmental factors play a major role in the etiology.