Based on the digital and network environment, this paper analyzes the problems existing in the teaching of traditional orthopedics in medical colleges and universities, including single teaching form, neglecting the students' practical skills and the phenomenon of students' poor learning initiative. It points out that the orthopedics teaching under the digital and network environment should be integrated through interactive teaching, multimedia teaching, WeChat network teaching, simulation teaching, practice teaching and other teaching forms and should pay attention to the reasonable use of teaching methods, make clear teachers and students' subject status, pay attention to students' learning ability training, so as to improve the teaching quality of orthopedics in medical colleges.

Objective To assess the effectiveness of Bankart repair under arthroscope in treatment of recurrent anterior shoulder joint instability. Methods From February 2010 to February 2015, 63 patients with recurrent anterior shoulder dislocation under arthroscipic Bankart repair, and 53 patients (28 male, 25 female) were available for follow-up. The mean age at the time of surgery was 27.9 years (range, 16 ~ 51). All of the 63 patients underwent surgical treatments, and the effectiveness was evaluated with University of California at Los Angeles (UCLA), American Shoulder and Elbow Surgeon scores (ASES), Constant-Murley scores, forward elevation, abduction and external rotation and X-ray. Results The ASES scores, UCLA scores were (97.0 ± 6.8), (29.6 ± 2.5) respectively, improved significantly higher after the surgery (P < 0.05). No significant change was found regarding Constant-Murley scores (99.1 ± 2.4), forward elevation (168.7 ± 2.7)°, abduction and external rotation (72.6 ± 8.7)° compared with the pre-operation. Conclusions Significant difference between pre-operation and post-operation suggests that Arthroscopic Bankart repair is a good option for the treatment of recurrent anterior shoulder dislocation without large glenoid bone loss and poor quality Ligament and joint capsule. Risk factors of recurrence should be evaluated before the surgery to reduce the recurrence rate of dislocation.

BACKGROUND:It is stil disputed about the treatment of subacromial impingement syndrome at present, arthroscopic subacromial decompression or open subacromial decompression. OBJECTIVE:To assess the clinical therapeutic effects of arthroscopic subacromial decompressionversus open subacromial decompression in the treatment of subacromial impingement syndrome. METHODS:Controled trials on arthroscopic subacromial decompressionversus open acromioplasty in the treatment of subacromial impingement syndrome were colected in different databases through computer search. There was no limitation for language, randomized controled trials or blinded studies. At last, the meta-analysis was conducted by using RevMan5.0 software. RESULTS AND CONCLUSION:Four randomized controled trials and six non-randomized controled trials were included in this study, involving 583 patients with subacromial impingement syndrome. The results of meta-analysis prompted that as to the hospital inpatient days and time until return to work, the group of arthroscopic subacromial decompression was shorter than open subacromial decompression. However, as to the postoperative shoulder functional scores, the operative time, patient’s satisfaction, and the rate of excelent and good results of postoperative UCLAs, there were no significant statistical differences between two groups. Due to the certain limitations and deficiencies of the quantity and quality in the included trials, there must stil need large-sample, multi-centered, high-quality randomized controled trials to confirm these results.

Objective: To investigate the effect of arthroscopic video teaching in clinical practice teaching of sports medicine. Methods: The undergraduate students of clinical medicine in Xinjiang Medical University who received practice teaching from April 2018 to July 2018 were selected and randomly divided into experimental group and control group. Students in the experimental group received arthroscopic video teaching, and those in the control group received traditional teaching. After the teaching ended, examination scores and pass rate were analyzed, and the degree of satisfaction with teaching method among students was also evaluated. Results: Compared with the control group, the experimental group was better at learning the anatomy of tissue and organs, understanding the pathological features and diagnosis of disease, understanding the surgical procedures, memorizing diseases and had better interests and efficiency in learning (P<0.05). The experimental group had a significantly higher degree of satisfaction with teachers than the control group (95.83% vs. 71.42%, P<0.05). Compared with the control group, the experimental group had significantly higher examination scores of operation skills (87.84±5.35 vs. 73.79±8.72, P<0.05) and pass rate (95.83% vs. 85.71%, P<0.05). Conclusion The implementation of arthroscopic video teaching can significantly improve students' learning interest, academic scores, and satisfaction with teacher, and therefore, it holds promise for application in clinical practice of sports medicine.

OBJECTIVE: To investigate the incidence and infection regularity of ventilator-associated pneumonia (VAP) in patients undergoing tracheal intubation and to provide reference for the prevention and treatment of VAP infection in the future. METHODS: A retrospective study was conducted to collect the microbial data of airway secretion cultures from 72 patients with endotracheal intubation admitted to the emergency ward of Shanghai Fifth People's Hospital from May 2020 to February 2021, and the species of microorganisms and intubation time were statistically analyzed. RESULTS: Among 72 patients with endotracheal intubation, males were more than females (58.33% vs. 41.67%); Patients over 60 years old accounted for 90.28%; pneumonia was the main primary disease, accounting for 58.33%. Pathogenic tests showed that: (1) 72 patients were infected with Acinetobacter baumannii (AB), Klebsiella pneumoniae (KP), and Pseudomonas aeruginosa (PA) 48 hours after intubation, 51.39% (37/72), 27.78% (20/72), and 26.39% (19/72), respectively. The infection rate of AB was significantly higher than that of KP and PA. Within 48 hours of intubation, the infection rates of AB, KP, and PA were 20.83% (15/72), 13.89% (10/72), and 4.17% (3/72), respectively. Of the 42 patients with primary pneumonia, 61.90% (26/42) were infected with one or more of the three pathogenic bacteria AB, KP, and PA 48 hours after intubation, indicating a change in the etiology of the pathogenic bacteria, with the main pathogenic bacteria transitioning from other pathogenic bacteria to AB, KP, and PA. (2) AB, KP, and PA were prone to cause late onset VAP (i.e., intubation ≥ 5 days). Respectively, among VAP patients infected with AB, late onset VAP accounted for 59.46% (22/37). Among patients infected with KP, 75.00% (15/20) had late onset VAP. Among patients infected with PA, late onset VAP accounted for 94.74% (18/19), indicating a higher proportion of late onset VAP caused by PA and KP. (3) Infection was closely related to intubation time, and the pipeline can be replaced according to the peak period of infection. AB and KP infections peaked within 4 days after intubation, reaching 57.69% (30/52) and 50.00% (15/30), respectively. It is recommended to replace the tubes or undergo sensitive antimicrobial therapy around 3-4 days after starting the machine. The proportion of PA infection after 7 days of intubation was 72.73% (16/22), and it was considered to replace the pipeline after 7 days. (4) Most of the three pathogenic bacteria, AB, KP, and PA were carbapenem resistant pathogens with multiple drug resistance. Except for PA, the infection rate of carbapenem resistant bacteria (CRAB, CRKP) was significantly higher than that of non-carbapenem resistant bacteria (AB, KP), accounting for 86.54% (45/52) and 66.67% (20/30) of the corresponding infection cases, respectively, while CRPA only accounts for 18.18% (4/22). CONCLUSIONS The main differences in VAP infection caused by AB, KP, and PA pathogens are infection time, infection probability, and carbapenem resistance. Targeted prevention and treatment measures can be implemented for patients with intubation.
Female ; Male ; Humans ; Middle Aged ; Pneumonia, Ventilator-Associated ; Retrospective Studies ; China ; Intubation, Intratracheal ; Acinetobacter baumannii ; Klebsiella pneumoniae