Objective To investigate the freatment outcome of internal fixation of the metacarpal and phalanx fracture using the pure fitanium mini plate.Methods 42 cases(78 lesions) of metacarpal and phalanx fracture were involved.Internal fixation with custom made pur titanium mini plate was done.Results Postoperative follow up rauged from 3 to 14 months and the fracture was healed in 42 cases.The bone union of roantgenographic eridence was 6 to 12 weeks.According to the functional evaluation of TAM ascles the excellent and good rate was 85.7%.Conclusion The AO mini-plate in treatment of the metacarpal and phalax fracture has a firm fixation.It is an optimal strategy for metarcarpal and phalanx fracture.

Objective To investigate whether the implanted spike wave electrical stimulation (ES) can improve survival of mesenchymal stem cells (MSCs) after transplantation in spinal cord injury (SCI) rats. MethodsIn the study,60 male SD rats were used to prepare the SCI induced by a digital weight drop apparatus.The MSCs from each rat' s femurs were collected and then labeled by Bromodeoxyuridine (Brdu) seven days after SCI.The rats were randomly assigned into four groups,ie,group A (receiving a transplantation of MSCs only),group B (receiving electro-stimulant therapy only),group C ( receiving a transplation of MSCs and electro-stimulant therapy) and the control group ( receiving a single injection of phosphate buffer solution,PBS).Functional status was assessed regularly before and after SCI by using the Basso-Beattie-Bresnahan (BBB) locomotor rating score and somatosensory evoked potential (SEP).The recovery of spinal cord was checked by diffusion tensor imaging (DTI) and the survivorship of the labeled MSCs was observed with immunohistochemical method. Results BBB score of group C demonstrated significant difference in comparison with that of the other three groups ( P ＜ 0.05 )and was significantly higher than that of the control group (P ＜0.01 ) four weeks after surgery,which indicated an obvious functional improvement of the extremity mobility in group C.At the 8th week postoperatively,SEP study displayed significant difference in group C from the other three groups in terms of latency and wave amplitude (P ＜0.05 ),indicating the fast neurofunctional recovery of the spinal cord in group C.MR images of the spinal cords by DTI showed the same outcome.Immunohistochemistry confirmed a large number of the labeled MSCs positive cells in the lesion site of group C.ConclusionTheimplanted spike wave ES promotes the bioactivity and survival of MSCs and improves the therapeutic effect in combination with MSCs transplantation.

ObjectiveTo identify high-risk factors and high-risk process of nosocomial infection， and then take targeted prevention and control measures to improve nosocomial infection management. MethodsWe identified and determined the risk factors associated with nosocomial infection by using an expert brainstorming method， and then conducted risk assessment of the factors in the outcomes and process by using a semi-quantitative method. ResultsA total of 31 experts participated in the risk factor assessment. Risk assessment scores showed that nosocomial infection due to multi-drug resistant bacteria was the highest risk in the outcomes of nosocomial infection. Lack of isolation for airborne/droplet transmission， needle/sharp instrument injury， inadequate identification of infection risk and response measures in construction engineering， and insufficient implementation of infection control system were extremely high risk factors in the process of nosocomial infection. ConclusionPrevention and control should be strengthened on multi-drug resistant bacteria and catheter-related infections. The role of multidisciplinary team （MDT） in the prevention and control of nosocomial infection should be enhanced in medical practice. Risk assessment may facilitate the resource allocation and improve hand hygiene behavior.

OBJECTIVE: To explore the integration method and technical realization of artificial intelligence bone age assessment system with the hospital RIS-PACS network and workflow. METHODS: Two sets of artificial intelligence based on bone age assessment systems (CHBoneAI 1.0/2.0) were developed. The intelligent system was further integrated with RIS-PACS based on the http protocol in Python flask web framework. RESULTS: The two sets of systems were successfully integrated into the local network and RIS-PACS in hospital. The deployment has been smoothly running for nearly 3 years. Within the current network setting, it takes less than 3 s to complete bone age assessment for a single patient. CONCLUSIONS The artificial intelligence based bone age assessment system has been deployed in clinical RIS-PACS platform and the "running in parallel", which is marking a success of Stage-I and paving the way to Stage-II where the intelligent systems can evolve to become more powerful in particular of the system self-evolution and the "running alternatively".
Age Determination by Skeleton ; Artificial Intelligence ; Bone and Bones ; Hospital Information Systems ; Hospitals ; Humans ; Radiology Information Systems ; Systems Integration

ObjectiveTo explore the effects of after-school tutoring for school-age children on their emotions and behaviors， and to provide a basis for developing after-school tutoring and psychological support strategies for school-age children. MethodsFour elementary schools in a district of Shanghai were selected by simple random sampling method. Whole group sampling was conducted by class， and parents of students were surveyed by general questionnaire and the scale of strengths and difficulties. Information was collected on the basic conditions of children and families and the results were compared and analyzed. ResultsThis study showed that 88.26% of children attended extracurricular classes， of which 26.16% attended 3 or more classes， 42.5% attended cultural classes， 28.3% attended sports classes， and 59.8% attended art classes. Children who did not attend classes had higher pro-social scores. Children who attended reading class had lower scores for emotional problems that was a protective factor for emotional problems. Children who chose extracurricular programs in sports and reading also had lower overall scores for difficulties. Excessive use of electronic devices by school-age children on weekdays or weekends had a negative effect on emotional and conduct problem scores regardless of whether they chose extracurricular programs. It appeared that the choice of cultural programs， art programs and different levels of exercise intensity had no effect on children's emotions and behaviors. ConclusionFor children with low pro-social level， extracurricular classes should be carefully selected. For extracurricular classes， more reading and sports-related courses can be considered， which have positive effects on school-age children’s emotions and behaviors. Regardless of the choice of extracurricular classes， try to avoid excessive online classes.