1.Application of pressure-protective brace in the rehabilitation training for the elder patients after surgical operation of femoral intertrochanteric fracture
Qi WANG ; Xuexi DUAN ; Jiangtao YAN ; Huiping SONG ; Teishi ZHAO ; Zhiqiang WANG ; Shenghua ZHANG ; Liquan CHEN
Clinical Medicine of China 2011;27(1):19-22
Objective To observe the effect of pressure-protective brace with pressure-sensitive device in the early stage rehabilitation training enhance bone healing, shorten the treatment course and reduce complications,a kind of independently developed pressure-protective brace with pressure-sensitive device was utilized with quantified discontinuous longitudinal stress stimulation under doctors' regulation according to procedure. Methods The pressure-protective brace with pressure sensitive device for rehabilitation training was developed in May 2008 ,and was applied in clinics during January 2009 to June 2010. Forty elder patients,with complete clinical data, underwent Dynamic Hip Screw (DHS) internal fixation of femoral intertrochanteric fracture were were enrolled into this study. These cases were assigned into experimental group and control group with 20 patients respectively. The patients of experimental group performed lower extremity rehabilitation training wearing the pressure-protective brace. The load training of lower extremities with double crutches was modulated by doctors through regulating the threshold value of pressure in different time and different condition after operation according to the prearranged rehabilitative plan of individuation. The controls were instructed to performed lower extremity rehabilitation training in traditional way. Both the clinical healing and bone union time in all cases were evaluated according to the uniform standard. Results Total 40 patients were followed up for 13.0 - 24. 0 weeks ( average, 17.6 weeks ). Clinical healing time was 7.0 - 12. 0 weeks ( average,9. 1 weeks ) and bone healing time was 12. 0 - 16.0 weeks(average,13. 7 weeks)in experimental group. While in control group,the clinic healing time and bone union time was 9. 0 - 13.0 weeks( average, 11.3 weeks) and 14. 0 -20. 0 weeks (average, 16. 6 weeks)respectively. The Independent T-test results showed that whether clinic healing time or bone healing time presented significant differences between experimental group and the controls( P<0. 01 ). All of the fractures in these two groups were healed at the end time of follow up without adverse complications,including fracture displacement, implant break, implant loose and failure. Conclusion The pressure-protective brace with pressure sensitive device used for quantifying rehabilitation training can enhance bone union, shorten the treatment course and reduce complications. This method further proves that discontinuous compressive stress in a certain range can stimulate fracture healing.
2.Exploration on Cognitive Differences and Improvement Approaches of "Internet+" Doctor-patient Relationship from the Dual Perspective of Doctors and Patients
Chinese Medical Ethics 2023;36(9):1022-1029
The multi-dimensional embedding of "Internet+" has led to new evolutions in the operating environment, service methods, interpersonal relationships. in the medical field, and promoted the transformation of the traditional face-to-face consultation and the physician-dominated interaction model. Based on the dual perspective of doctors and patients, taking the demands of stakeholders under "Internet+Medical" as entry point, this paper analyzed the dual impact of "Internet+" on the doctor-patient relationship and explored the reconstruction countermeasures of doctor-patient relationship under "Internet+". This paper found that the doctors’ cognition of "Internet+Medical" was not high, leading to the limited scope of service supply, patients had a low awareness of "Internet+Medical", resulting in a narrow range of service audiences, "Internet+Medical" helped to improve the accessibility of resources and had the possibility of increasing risks for both doctors and patients. In response, some countermeasures were proposed, including strengthening the government’s supervision and management to promote the online safe interaction and orderly communication between doctors and patients, strictly investigating the qualifications of doctors and information management on internet platforms to protect the legitimate rights and interests of both doctors and patients, cultivating doctors’ medical humanistic literacy to improve the non-technical communication relationship between doctors and patients, enhancing patients’ personal health literacy and maintaining appropriate expectations of doctors and services, adhering to the appropriate expectations of doctors and services, and urging the media to promote and report objectively and impartially to create a good atmosphere of mutual trust between doctors and patients.