OBJECTIVE: To compare the clinical efficacy of jingjin needling combined with rehabilitation training and conventional acupuncture combined with rehabilitation training for post-stroke spastic paralysis. METHODS: A total of 60 patients with post-stroke spastic paralysis were randomly divided into an observation group and a control group, 30 cases in each one. Both groups received conventional rehabilitation training. In the observation group, jingjin needling was applied at tendon blockage points of the shoulder, elbow, wrist, hip, knee, and ankle. In the control group, conventional acupuncture was applied at Jianyu (LI15), Quchi (LI11), Hegu (LI4), Biguan (ST31), Fengshi (GB31), Taichong (LR3), etc. on the affected side. Treatment was given once daily, 5 days a week for 4 weeks in both groups. The scores of clinical spasticity index (CSI), modified Ashworth scale, modified Barthel index (MBI), and Fugl-Meyer assessment scale (FMA) were evaluated before and after treatment, and the onset time was compared between the two groups. RESULTS: After treatment, the scores of CSI and modified Ashworth scale were decreased compared with those before treatment (P<0.001), while the scores of MBI and FMA were increased compared with those before treatment (P<0.001) in the two groups. After treatment, the scores of CSI and modified Ashworth scale in the observation group were lower than those in the control group (P<0.05), the MBI score in the observation group was higher than that in the control group (P<0.05). There was no statistically significant difference in FMA scores between the two groups (P>0.05). The onset time of the observation group was earlier than that in the control group (P<0.05). CONCLUSION Both jingjin needling combined with rehabilitation training and conventional acupuncture combined with rehabilitation training can effectively treat post-stroke spastic paralysis, jingjin needling combined with rehabilitation training exhibits better therapeutic effect and rapider onset.
Humans ; Acupuncture Therapy ; Male ; Female ; Middle Aged ; Aged ; Stroke/complications* ; Adult ; Acupuncture Points ; Muscle Spasticity/etiology* ; Treatment Outcome ; Stroke Rehabilitation ; Paralysis/therapy* ; Combined Modality Therapy

Objective:To explore the feasibility and consistency of a new digital classification system of pelvic fractures named as JST classification based on close reduction techniques.Methods:A retrospective collection was conducted of the data from the 63 patients with pelvic fracture who had undergone surgical treatment after JST classification at Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital from March 2021 to March 2023. Digital classification of the pelvic fractures was performed based on their locations and displacements. The classification first divides the pelvis into 4 parts: left half pelvis and right half pelvis; sacral Denis Ⅲ area and pubic symphysis. The symmetrical left and right sacral Denis Ⅰ and Denis Ⅱ areas are also included in the left/right half pelvis. Subsequently, the left half pelvis and right half pelvis are divided into 4 regions and marked by capitalized English letters: Sacrum Area (including Denis Ⅰ and Denis Ⅱ, denoted as S), Sacroiliac Joint Area (denoted as J), Iliac Area (denoted as I), and Pubic Area (denoted as P); to distinguish right/left, R and L are used as prefixes. The 2 asymmetric parts are also marked with English letters: Denis Ⅲ area of the sacrum (denoted as Sac), and pubic symphysis (denoted as C). Afterwards, the fracture line morphology and displacement in each region are marked digitally to form a complete JST classification system. The inter- and intra-observer reliabilities (Fleiss' and Cohen's Kappa) of the JST classification system were tested by 3 observers with more than 10 years of experience in pelvic fracture treatment.Results:Consistency analysis of the JST classification results showed that the mean κ value of the intra-observer reliability was 0.818 (from 0.658 to 0.946, P<0.001) and the inter-observer reliability 0.873 (from 0.674 to 1.000, P<0.001), both indicating excellent agreement. Of the 63 patients, 59 obtained successful closed reduction with the assistance of the Rossum Robot R-Universal intelligent orthopedic surgical robot system after fracture classification by the JST system, yielding a success rate of 93.7% (59/63). Conclusions:The new JST classification system for pelvic fractures demonstrates strong intra and inter-observer reliabilities compared with traditional classification systems. As JST classification system labels each fracture site and key bones, it is of great significance for the deep learning and intraoperative operations of intelligent fracture robots.

Objective:To elucidate the recent therapeutic efficacy of the intelligent fracture reduction robotic system in managing pelvic fractures.Methods:A retrospective evaluation of 49 pelvic fracture patients treated using the intelligent fracture reduction robotic system at Beijing Jishuitan Hospital's trauma orthopedics department between March 2021 and December 2022 was conducted. The cohort included 30 males and 19 females, with a mean age of 51.51±18.71 years (20-92 years range). Fractures were classified according to the Tile system: B1 type in 2 cases, B2 in 7, B3 in 3, C1 in 30, and C2 in 3. The median interval between injury and surgery was 6 days, with a range of 2-22 days. The robotic system assisted in pelvic fracture reduction and stabilization surgeries. Preoperative and postoperative evaluations involved pelvic CT scans, anteroposterior, inlet, and outlet radiographic images. Fracture displacement and reduction outcomes were assessed via X-ray imagery. Data captured included intraoperative blood loss, duration of surgery, fracture stabilization techniques, and postoperative monitoring period. The Majeed scoring system gauged functional outcomes.Results:Of the patients, 48 underwent minimally invasive interventions with robotic assistance, while one case necessitated open reduction and internal fixation due to an unsuccessful reduction. The duration between injury and operation ranged from 2 to 22 days. Average surgical time stood at 206.5±7.1 minutes (105-440 min range), and median intraoperative blood loss was 100ml (10-600 ml range). Using the Matta reduction criteria, 30 postoperative cases exhibited excellent and 9 good outcomes for posterior pelvic ring displacement, translating to a 93% (38/41) positive rate. For anterior pelvic ring shifts, 45 showed excellent and 3 good outcomes, culminating in a 100% (48/48) success rate. Follow-up for the 48 cases lasted 11.0 months (3-23 months range), with the Majeed functional score averaging 81.9±17.0 points (42-100 point range). 27 cases scored excellent, and 11 good, yielding a combined positive outcome rate of 79.2% (38/48).Conclusion:Employing the intelligent fracture reduction robotic system in pelvic fracture treatments facilitates minimally invasive interventions and yields favorable short-term clinical results.

Objective:To introduce an innovative simulation training system of liposuction and compare the effect of the traditional training method with this system in the liposuction training for medical students.Methods:Thirty medical postgraduates (18 males and 12 females, aged 22 to 30 years) at Peking Union Medical College without liposuction experiences were selected. All the participants were randomly divided into two groups. In the traditional training group, the trainees were trained on the phantom, while the teachers gave explanations and demonstrations. In the simulation training system group, the trainees were trained by themselves on the simulation training system. Before and after the training, the two groups were required to perform a liposuction simulation test on the simulated training system. The resistance of liposuction cannula, the acceleration of liposuction cannula and the uniformity degree of operation of the two groups were recorded, and the differences in the training effects between the two groups were compared. R 3.5 and Python 3.7 were used for analysis. Application of the t test for measurement data was in accordance with normal distribution, and the results were expressed as Mean±SD deviation. Application of Wilcoxon signed-rank test or Wilcoxon rank sum test for the measurement data did not conform to the normal distribution. The results were expressed as M( P25, P75). P< 0.05 indicated statistical differences. Results:After the training, the area of liposuction in the traditional training group was more moderate than that before the training [skewness: -0.22(-0.38, -0.14) vs. -0.07(-0.24, 0.02)( V=20, P=0.022); kurtosis: 2.32(2.09, 2.58) vs. 1.96(1.90, 2.00)( V=112, P=0.002)]. After training, the number of times of lateral resistance[7.0(3.5, 13.5) vs. 0(0, 0)( V=111.5, P=0.004)] and acceleration [7.0(5.0, 17.5) vs. 3.0(2.0, 12.5)( V=102, P=0.002)] over-threshold were significantly reduced, the angle of liposuction coverage [131.18°(117.71°, 137.88°) vs. 169.89°(162.96°, 180.00°)( V=0, P<0.001)] was significantly improved, and the area of liposuction [skewness: -0.17(-0.33, 0.03) vs. -0.01(-0.13, 0.06)( V=21, P=0.026); kurtosis: 2.35(2.08, 2.50) vs. 1.94(1.83, 2.00)( V=118, P<0.001)] was more evenly distributed. The differences before and after training were analyzed between the simulation training system group and the traditional training group. The simulation training system group was superior to the traditional training group in the number of times of lateral resistance[-7.5±7.4 vs.-1.4±9.0 ( t=111.5, P=0.026)], the number of times of acceleration [-3.0(-6.5, -2.0) vs. -1.0(-4.0, 2.0)( W=156.5, P=0.035)] and the angle of coverage[(-40.24±18.88)° vs. (-11.10±25.54)° ( t=3.553, P<0.001)]. Conclusions:Simulation training system is an effective method in liposuction training to enhance the skills of trainees.

Objective:To introduce an innovative simulation training system of liposuction and compare the effect of the traditional training method with this system in the liposuction training for medical students.Methods:Thirty medical postgraduates (18 males and 12 females, aged 22 to 30 years) at Peking Union Medical College without liposuction experiences were selected. All the participants were randomly divided into two groups. In the traditional training group, the trainees were trained on the phantom, while the teachers gave explanations and demonstrations. In the simulation training system group, the trainees were trained by themselves on the simulation training system. Before and after the training, the two groups were required to perform a liposuction simulation test on the simulated training system. The resistance of liposuction cannula, the acceleration of liposuction cannula and the uniformity degree of operation of the two groups were recorded, and the differences in the training effects between the two groups were compared. R 3.5 and Python 3.7 were used for analysis. Application of the t test for measurement data was in accordance with normal distribution, and the results were expressed as Mean±SD deviation. Application of Wilcoxon signed-rank test or Wilcoxon rank sum test for the measurement data did not conform to the normal distribution. The results were expressed as M( P25, P75). P< 0.05 indicated statistical differences. Results:After the training, the area of liposuction in the traditional training group was more moderate than that before the training [skewness: -0.22(-0.38, -0.14) vs. -0.07(-0.24, 0.02)( V=20, P=0.022); kurtosis: 2.32(2.09, 2.58) vs. 1.96(1.90, 2.00)( V=112, P=0.002)]. After training, the number of times of lateral resistance[7.0(3.5, 13.5) vs. 0(0, 0)( V=111.5, P=0.004)] and acceleration [7.0(5.0, 17.5) vs. 3.0(2.0, 12.5)( V=102, P=0.002)] over-threshold were significantly reduced, the angle of liposuction coverage [131.18°(117.71°, 137.88°) vs. 169.89°(162.96°, 180.00°)( V=0, P<0.001)] was significantly improved, and the area of liposuction [skewness: -0.17(-0.33, 0.03) vs. -0.01(-0.13, 0.06)( V=21, P=0.026); kurtosis: 2.35(2.08, 2.50) vs. 1.94(1.83, 2.00)( V=118, P<0.001)] was more evenly distributed. The differences before and after training were analyzed between the simulation training system group and the traditional training group. The simulation training system group was superior to the traditional training group in the number of times of lateral resistance[-7.5±7.4 vs.-1.4±9.0 ( t=111.5, P=0.026)], the number of times of acceleration [-3.0(-6.5, -2.0) vs. -1.0(-4.0, 2.0)( W=156.5, P=0.035)] and the angle of coverage[(-40.24±18.88)° vs. (-11.10±25.54)° ( t=3.553, P<0.001)]. Conclusions:Simulation training system is an effective method in liposuction training to enhance the skills of trainees.

Objective To explore the management of postoperative infection following open reduction and internal fixation for acetabular fractures.Methods Ten patients were treated and completely followed up in Beijing Jishuitan Hospital from February 2012 to December 2016 for postoperative infection after open reduction and internal fixation for acetabular fracture.They were 9 males and one female,aged from 14 to 64 years(mean,40.6 years).According to Letournel classification,there were 2 double-column fractures,2 anterior descending transverse fractures,2 anterior column fractures,one posterior wall fracture,and one posterior wall fracture.Eight cases developed surgical regional infection within 2 weeks after internal fixation,and 2 presented with symptoms of infection more than 3 months after fracture fixation.Vacuum sealing drainage (VSD) was used to treat one case of acute superficial infection;open debridement surgery,carrier with sensitive antibiotics and intravenous antibiotics were used to treat 7 cases of acute deep infection and 2 cases of chronic deep infection.Results The infection symptoms disappeared 9 days after removal of VSD device in the one case of acute superficial infection.Normal fracture union was achieved in 6 cases after their infection was controlled;4 cases had to undergo total hip arthroplasty because their articular structure was damaged after control of infection.The 10 patients were followed up for 6 to 54 months (mean,25.7 months).Their Harris scores at the last follow-up averaged 74.8 (from 32 to 92).Conclusions Negative-pressure wound therapy is an effective management for acute superficial infection after acetabular fracture.Deep acute infection needs early repeated debridement combined with sensitive antibiotic carrier to protect joint function.For infection which is difficult to control or chronic infection associated with structural damage,repeated debridement combined with sensitive antibiotic spacer is effective for infection control at the first stage and artificial total hip arthroplasty can be carried out at the second stage when the infection is controlled.