Objective:To explore the effect of mobile medical intelligent software combined with OBE-CBCL dual-track teaching method in standardized training of orthopaedic residents.Methods:The orthopedic residents who received resident standardized training in our hospital from Jan 2022 to Sep 2022 were selected as the study subjects.The orthopedic residents who received regular teaching method from Jan 2022 to Mar 2022 were group A,orthopedic residents who received mobile medical intelligent software + regular teaching method from Apr 2022 to Jun 2022 were group B,and the orthopedic residents who received mobile medical intelligent software + OBE-CBCL dual-track teaching method from Jul 2022 to Sep 2022 were group C.All three groups participated in the relevant professional theoretical knowledge assessment,Mini-CEX,and satisfaction survey at the time of discharge.Results:The scores of professional theoretical knowledge assessment in groups B and C were higher than that in groups A,and it was higher in group C than that in group B(P＜0.05).The scores of each item of Mini-CEX in groups B and C were higher than those in group A(P＜0.05).Except for clinical judgment ability,the scores of the other items of Mini-CEX in group C was higher than those in group B(P＜0.05).In the satisfaction survey,the scores of deepening knowledge mastery in groups B and C were higher than that in group A,and that in group C was higher than that in group B(P＜0.05).The scores of improving clinical thinking and stimulating learning interest in groups B and C were higher than those in group A(P＜0.05),and the scores of improving team assistance and overall satisfaction in group C were higher than those in groups A and B(P＜0.05).Conclusion:Mobile medical intelligent software combined with OBE-CBCL dual-track teaching can significantly improve teaching effect of orthopaedic resident standardized training.

Objective:To explore the characteristics of glucose and lipid metabolism and intrauterine growth indicators in fetuses with selective intrauterine growth restriction (sIUGR) in twins.Methods:Sixty cases of sIUGR type I twin fetuses who were registered, underwent regular prenatal care, and were hospitalized for delivery at the Fujian Maternity and Child Health Hospital from January 2021 to January 2023 were selected as the research subjects. Selected 30 fetuses with growth restriction from sIUGR pregnant patients were taken as the observation group, while the 30 fetuses with non-growth-restricted served as the control group. During cesarean section, the umbilical vein blood of two fetuses was collected after the fetus was delivered and before the placenta was delivered, and the factors regulating growth, development and metabolism in the umbilical vein blood were detected: adiponectin, leptin, insulin-like growth factor-1 (IGF-1), blood glucose, total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A1, apolipoprotein B and other indicators. The measurement data of normal distribution are presented as xˉ± s, and the comparison of means between the two groups is performed using paired t-tests. P<0.05 was considered statistically significant. Results:(1) The levels of adiponectin (83.60±8.91) μg/L, leptin (7.11±0.53) μg/L, and IGF-1 (43.43±0.68) μg/L in the umbilical cord blood of the case group were significantly lower than those of the control group (92.50±10.52) μg/L, leptin (12.00±0.66) μg/L, and IGF-1 (70.34±1.44) μg/L, with statistically significant differences ( t-values of 2.94, 31.33, 99.70, respectively; P values of 0.006, <0.001, <0.001, respectively). (2) There was no statistically significant difference in the levels of blood glucose, triglycerides, HDL-C, and apolipoprotein A1 in umbilical cord blood between the two groups of fetuses (all P>0.05). (3) The total cholesterol (2.626±0.764) mmol/L, LDL-C (1.168±0.482) mmol/L, and apolipoprotein B (0.359±0.133) mmol/L in the umbilical cord blood of the case group were significantly higher than those in the control group, with total cholesterol (2.351±0.725) mmol/L and LDL-C (1.043±0.418) mmol/L. Apolipoprotein B was (0.317±0.107) mmol/L, and there was a statistically significant difference between the two groups ( t-values were 3.42, 3.10, and 3.67, respectively; and P values were 0.002, 0.004, and 0.001, respectively). Conclusion:There are abnormalities in lipid metabolism present in the cord blood of growth-restricted infants. Clinically, adiponectin, leptin, IGF-1, total cholesterol, LDL-C, and apolipoprotein B in twin umbilical blood can be served as key indicators for assessing fetal intrauterine development.

OBJECTIVE: To investigate the effect of ultrasonic bone curette in anterior cervical spine surgery. METHODS: A clinical data of 63 patients with cervical spondylosis who were admitted between September 2019 and June 2021 and met the selection criteria was retrospectively analyzed. Among them, 32 cases were operated with conventional instruments (group A) and 31 cases with ultrasonic bone curette (group B). There was no significant difference between the two groups (P>0.05) in gender, age, surgical procedure, surgical segment and number of occupied cervical space, disease type and duration, comorbidities, and preoperative Japanese Orthopaedic Association (JOA) score, cervical dysfunction index (NDI), and pain visual analogue scale (VAS) score. The operation time, intraoperative bleeding, postoperative drainage, postoperative hospital stay, and the occurrence of postoperative complications were recorded in both groups. Before operation and at 1, 3, and 6 months after operation, the JOA score and NDI were used to evaluate the function and the postoperative JOA improvement rate was calculated, and VAS score was used to evaluate the pain improvement. The anteroposterior and lateral cervical X-ray films were taken at 1, 3, and 6 months after operation to observe whether there was any significant loosening and displacement of internal fixators. RESULTS: Compared with group A, group B had shorter operation time and postoperative hospital stay, less intraoperative bleeding and postoperative drainage, and the differences were significant (P<0.05). All incisions healed by first intention in the two groups, and postoperative complications occurred in 5 cases (15.6%) in group A and 2 cases (6.5%) in group B, showing no significant difference (P>0.05). All patients were followed up 6-12 months (mean, 7.9 months). The JOA score and improvement rate gradually increased in groups A and B after operation, while the VAS score and NDI gradually decreased. There was no significant difference in VAS score between 3 months and 1 month in group B (P>0.05), and there were significant differences between the other time points of each indicator in the two groups (P<0.05). At 1, 3, and 6 months after operation, the JOA score and improvement rate in group B were better than those in group A (P<0.05). X-ray films examination showed that there was no screw loosening or titanium plate displacement in the two groups after operation, and the intervertebral cage or titanium mesh significantly sank. CONCLUSION Compared with traditional instruments, the use of ultrasonic bone curette assisted osteotomy in anterior cervical spine surgery has the advantages of shorter operation time, less intraoperative bleeding, less postoperative drainage, and shorter hospital stay.
Humans ; Ultrasonics ; Retrospective Studies ; Titanium ; Postoperative Complications/epidemiology* ; Bone Plates ; Cervical Vertebrae/surgery*

OBJECTIVE: To investigate the early effectiveness of the Ti-Robot assisted femoral neck system (FNS) in the treatment of elderly Garden type Ⅱ and Ⅲ femoral neck fractures. METHODS: A retrospective analysis was conducted on the clinical data of 41 elderly patients with Garden type Ⅱ and Ⅲ femoral neck fractures who were admitted between December 2019 and August 2022 and met the selection criteria. Among them, 21 cases were treated with Ti-Robot assisted FNS internal fixation (study group), and 20 cases were treated solely with FNS internal fixation (control group). There was no significant difference in baseline data, including gender, age, side, cause of injury, time from injury to surgery, fracture Garden classification, and fracture line classification, between the two groups ( P>0.05). Surgical effectiveness was evaluated based on parameters such as operation time (including incision time and total operation time), reduction level, number of dominant pin insertions, intraoperative fluoroscopy frequency, incision length, whether to extend the incision, need for assisted reduction, postoperative hospital stay, fracture healing time, incidence of osteonecrosis of the femoral head, postoperative visual analogue scale (VAS) score at 1 day, and Harris hip score at last follow-up. RESULTS: The study group showed significantly shorter incision time, fewer dominant pin insertions, fewer instances of extended incisions, fewer intraoperative fluoroscopy frequency, and smaller incisions than the control group ( P<0.05). There was no significant difference in total operation time, reduction level, and assisted reduction frequency between the two groups ( P>0.05). Both groups achieved primary wound healing postoperatively, with no complications such as incision leakage or skin infection. All patients were followed up 12-24 months with an average of 14.6 months. Fractures healed in both groups, with no significant difference in healing time ( P>0.05). There was no significant difference in postoperative hospital stay between the two groups ( P>0.05). The study group showed significantly better VAS score at 1 day after operation and Harris hip score at last follow-up when compared to the control group ( P<0.05). No complication such as internal fixation failure, fracture displacement, or hip joint varus occurred in both groups during the follow-up. Osteonecrosis of the femoral head occurred in 1 patient of the control group, while no was observed in the study group, and the difference in the incidence of osteonecrosis of the femoral head between the two groups was not significant ( P=0.488). CONCLUSION Compared to sole FNS internal fixation treatment, Ti-Robot assisted FNS internal fixation for elderly Garden typeⅡ and Ⅲ femoral neck fractures can reduce incision time, achieve minimally invasive and accurate nail implantation, and decrease intraoperative fluoroscopy frequency, leading to improved postoperative hip joint function recovery.
Humans ; Aged ; Femur Neck ; Robotics ; Retrospective Studies ; Treatment Outcome ; Titanium ; Femoral Neck Fractures/surgery* ; Fracture Fixation, Internal ; Osteonecrosis ; Surgical Wound

【Objective】 To investigate whether the current retention methods in blood stations can fully meet the traceability requirements of blood test results by analyzing the traceability of retained samples for syphilis antibody testing. 【Methods】 Thirty-four one-assay-positive deep-well plate retention samples, 68 double-assay-positive deep-well plate retention samples and 263 negative retention blood braids and corresponding deep-well plate retention samples that expired retention period for syphilis antibody testing from 2014 to 2020 in our center were collected. The TP-ELISA assays of two manufacturers were used for retesting, and the results were recorded and compared with the original results statistically. 【Results】 The concordance rate of the double-assay-positive and single-assay-positive samples with their corresponding deep-well plate samples was 98.53%(67/68) and 67.65%(23/34), respectively(P<0.05). Specific results for single-assay-positive syphilis antibody samples and their corresponding deep-well plate retention samples were as follows: 1) Single positive (reagent A): 13 out of 14 original samples were 0.65