Adult ; Humans ; Male ; Oils ; Pneumonia, Aspiration ; chemically induced

Objective To investigate the predictive value of trauma index on the prognosis in pa-tients with traumatic spinal cord injury.Methods Enrolled 168 cases of patients with traumatic spinal cord injury,the traumatic index score and the American Spinal Injury Association (ASIA)grade were as-sessed on admission,then followed up for 6 months,the Spearman correlation analysis was performed to a-nalysis the relationship between trauma index and ASIA grade,and Receiver operating curve (ROC)anal-ysis was used to evaluate the relationship between trauma index and prognosis.Results There was a sig-nificant negative correlation between trauma index score and ASIA grade(r =-0.68,P <0.01).A total of 157 cases (93.5%)completed follow-up,the trauma index score had a good predictive value on the traumatic death in these patients,it's sensitivity was 71.4%,specificity was 76.1%,the best cut-off point was 25 points(P <0.01 );Compared with the low score group (<25 points),the high group (≥25 points)showed a lower ASIA grade and higher mortality,the differences were statistically significant (P <0.01).Conclusion The trauma index score was related with the spinal cord injury,and it is a predictive factor of poor prognosis in patients with traumatic spinal cord injury.

Acupuncture Therapy ; history ; instrumentation ; methods ; China ; History, Ancient ; Humans ; Medicine in Literature ; Needles ; history

In order to solve the problem of poor communication, low efficiency of consultation, and even affecting self-confidence caused by unskilled skills and insufficient cooperation with patients in the real clinic, and to solve the problem during the clinical thinking training that beginners do not know how to organize effective information and complete the process of diagnosis and differential diagnosis more efficiently. By applying the artificial intelligence (AI) virtual patient (VP) system to the process of teaching diagnostic knowledge and clinical thinking training. It provides the students with the experience of simulating the diagnosis and treatment of the clinical real scene. Let the students talk with the VP system for inquiry training and then go to the clinic to give the real patients inquiry and by simulating the process of treating the real patients, let the students take the initiative to complete the collection of medical records and clinical decision-making under the simulated scene to train the clinical thinking. This can not only solve the shortcomings of the previous simulation teaching and clinical teaching, but also stimulate students' interest in learning. According to the results of the questionnaire, students have a high acceptance of VP system simulation teaching. Through the results of homework and assessment and evaluation, the teaching results are better than before, and this teaching method should be further popularized.

OBJECTIVE:To investigate the cognition,evaluation and demands of medical staff to the clinical pharmacy work in the secondary and tertiary medical and health institutions in Xi’an city,and provide reference for further promoting the develop-ment of the local clinical pharmacy work. METHODS:20 secondary and tertiary medical and health institutions in Xi’an city were randomly selected to conduct a random sampling questionnaire for physicians,nurses (senior nurses),pharmacists (non-clinical pharmacist)and other medical technicians. And the results were statistically analyzed. RESULTS:Totally 1 020 questionnaires were sent out,851 were effectively received with effective recovery of 83.4%. 45.9% respondents knew clinical pharmacy,and“Col-league”was the main channel;34.3% thought clinical pharmacy“only maintained normal operation. 74.7% surveyed medical staff,92.6% surveyed pharmacists and 70.6% surveyed physicians thought clinical pharmacists“should”take round with the doc-tors and nurses;44.3% respondents showed“dissatisfaction”and“general satisfaction”with the clinical pharmacy work in their hospitals. 48.5% respondents would take the initiative to consult the clinical pharmacist for medication;45.5% respondents partial-ly accepted the drug information provided by clinical pharmacists. There were significant differences in the investigation results in aspects of respondents’understanding level and channel for clinical pharmacy,cognition for development situation of clinical phar-macy,evaluation for clinical pharmacists participating round,demand for consulting the medication,acceptance for drug informa-tion provided by clinical pharmacists,and other items(P<0.05). CONCLUSIONS:The cognition and effect of clinical pharmacy work on medical staff need to be further strengthened,clinical pharmacists should also have solid clinical knowledge and the knowl-edge of medicine to meet the demand of medical staff in different positions,the acceptance of medical staff to the pharmaceutical care needs to be further improved. Clinical pharmacists should earnestly fulfill their job functions through various efforts to promote rational drug use.

Objective To evaluate the clinical efficacy of the application of auricular composite tissue flap in treatment of nasal alar de-fect. Methods 43 cases of nasal defects patients were admitted to our hospital from January 2008 to March 2013, 23 cases of them were treated with auricular composite tissue flap transplantation, and the other 20 cases were given nasolabial sulcus flap transfer operation. All patients were followed-up for 6 to 12 months, and the rate of secondary surgery, proliferation of scar, and flap survival of the two groups were compared. Results Treatment of auricular composite tissue flap transplantation has more advantages in terms of the rate of secondary surgery, proliferation of scar, and flap survival, and the difference is of statistical significance (P<0. 05). And there is no obvious differ-ence in satisfaction degree of cosmetic outcomes. Conclusion Auricular composite tissue flap surgery has the advantages of simple opera-tion, good appearance and good efficacy.

OBJECTIVETo investigate the correlation of morphological characteristics and failure modes of two types of glass-fiber posts luted with self-adhesive resin cement and etch-and-rinse adhesive system.

METHODSThirty-six intact single-rooted premolars were collected and removed the crown. After root canal therapy, teeth were randomly divided into 4 groups. Group A: Self-adhesive with POPO fiber post. Group B: Etch-and-rinse with POPO fiber posts. Group C: Self-adhesive with Para Post. Group D: Etch-and-rinse with Para Post. Each root was sectioned into six 1 mm-thick serial slices and a push-out test was performed. The dentin-cement-post adhesive interface of each specimen and failure modes after fracture were evaluated by stereomicroscope observation.

RESULTSInterface morphology observe indicated that voids present in group B (64.2%) and D (66.7%) were significantly higher than group A (5.8%) and C (13.7%) (P < 0.001). Interface gaps appeared at the resin-dentine interface in group D (41.2%) were significantly higher than group A (13.5%) and C (11.8%) (P < 0.0083), and the failure modes in each group were significantly different (P < 0.0083) except for group A and B (P = 0.69).

CONCLUSIONVoids present in cement layer were associated with the luting agent involved. Morphological characteristics of the fiber post-resin luting agent-root dentin adhesive interface were discrepant with failure modes in different root region. There were interaction between adhesive systems and fiber posts.

Adhesives ; Composite Resins ; Dental Bonding ; Dental Pulp Cavity ; Dentin ; Dentin-Bonding Agents ; Glass ; Humans ; Methacrylates ; Post and Core Technique ; Resin Cements ; Tooth Root

BACKGROUND:Many studies have demonstrated that restoration of femoral offset in revision total hip arthroplasty would contribute to the recovery of joint function.OBJECTIVE:To investigate the importance of restoration of femoral offset in revision total hip arthreplasty on the recovery of joint function.METHODS:An observational study was performed at the Department of Orthopedics,Third Affiliated Hospital of Guangzhou Medical University between February 2004 and May 2007.A total of 15 patients with the revision total hip arthroplasty,including 12 males and 3 females,aging 62 75 years,averaging 67 years old,were recruited into this study.Harris evaluation system was used to evaluate joint function.The femoral neck anteversion and the femoral offset were measured by the method of Sakai.The vertical distance from the teardrop line to the most prominent point of the lesser trochanter was measured from each radiograph.References were combined to investigate the effect of restoration of femoral offset in revision total hip arthroplasty on joint function.RESULTS AND CONCLUSION:All the 15 patients were recruited into this study.The duration of follow-up ranged from 24 months to 5 years.We measured the femoral offset on pre- and post-operative radiographs,and the results indicated that the femoral offset of 4 patients were above 4 mm.The femoral offset of 11 patients was restored.The femoral offset were 22-48 (32.21±0.64) mm pre- and 22-57 (36.13±0.82) mm post-operative radiographs,respectively.The mean difference in femoral offset post-operatively was significant (t=0.424,P=0.01 ).Harris scores were good in 4 cases,passable in 2 cases,and poor in 9 cases pre-operatively,and the scores were excellent in 8 cases,good in 4 cases,passable in 2 cases,and poor in 1 case post-operatively.The score of Harris evaluation system in the patient of restoration group and failed restoration group were 88.72±5.3 (80%) and 72.32±6.5 (27%) post-operative at 1 month respectively.The mean difference of the score was significant (χ~2=1.245,P<0.05).The 3 patients had complication,one was the dislocation of hip,and two had the pain of hip.All the patients with complication were in failed restoration of femoral offset,which was above 4 mm.The restoration of femoral offset contributes to the recovery of joint function and reduce complication occurrence after total hip arthroplasty revision.

OBJECTIVETo evaluate the role of serum level of procalcitonin (PCT), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell count (WBC) as predictors in postoperative early infectious complications with fever after posterior lumbar internal fixation (PLIF).

METHODSA retrospective study was conducted from January 2012 to January 2014. Fifty-two patients with fever in the early stage(within 10 days) after the PLIF were collected in the study. They were divided into infection group and non-infection group (group A and group B) according to the results of postoperative blood culture. There were 26 patients in group A and 32 patients in group B. The values of PCT, CRP, ESR, and WBC count were compared and analyzed between two groups.

RESULTSThe values of PCT, CRP, and ESR in group A were higher than those of group B. Meanwhile, CRP and ESR in group B were still higher than the normal range. Among the 26 patients with infections (group A), PCT was superior to CRP and ESR, had a good ability in discriminating different kinds of postoperative infections. The area under the ROC curve of serum PCT levels was the largest (CI 95% was 0.81 to 0.98) in the indexs; and ROC curve of WBC count was no statistically significant. When the cut off points of each predictors were evaluated, the higher sensitive was CRP and reached at 90.27% and the higher specific was ESR and reached at 88.50%.

CONCLUSIONFor the patients with fever at the early stage after the PLIF should be paid attention and reasonable choosing predictors are helpful to identify postoperative infection in the early stage. The CRP and ESR may be influenced by the surgery, and the PCT level is helpful to differentiate infection type.

Adult ; Aged ; Aged, 80 and over ; Blood Sedimentation ; C-Reactive Protein ; analysis ; Calcitonin ; blood ; Calcitonin Gene-Related Peptide ; Female ; Fever ; blood ; diagnosis ; Fracture Fixation, Internal ; adverse effects ; Humans ; Infection ; blood ; diagnosis ; Leukocyte Count ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Postoperative Complications ; blood ; diagnosis ; Protein Precursors ; blood

Diagnosis, Differential ; Endometrial Stromal Tumors ; metabolism ; pathology ; surgery ; Female ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; pathology ; Humans ; Leiomyoma ; metabolism ; pathology ; Middle Aged ; Neprilysin ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Rectal Neoplasms ; metabolism ; pathology ; surgery ; Rectum ; surgery ; Solitary Fibrous Tumors ; metabolism ; pathology