To increase efficiency of automated leucocyte pattern recognition using lower feature dimensions, a novel inter-class distinctive feature selection method for chromatic leucocyte images was proposed based on attribute hierarchical relationship. According to the attribute constraints in formal concept analysis, we established a knowledge representation and discovery method based on the hierarchical optimal diagram by defining attribute value and visual representation of optimized hierarchical relationship. It was applied to human peripheral blood leucocytes classification and 12 distinctive attributes were simplified from 60 inter-class attributes, which contributes significantly to reduced feature dimensions and efficient inter-class feature classification. Compared with the classical experimental data, the inter-class distinctive feature selection method based on hierarchical optimal diagram was proved to be usable and effective for six leucocyte pattern recognition.
The article summarized the national and international history and current situation of healthcare-associated infection control, and analyzed the tendency of new technique and progress in healthcare-associated infection control according to the experience in research and practice.
ObjectiveTo summarize the evolving concept in treatment of intertrochanteric fractures and the development of internal fixation devices. MethodsRelated literature concerning the implant devices to treat intertrochanteric fractures was reviewed and analyzed in terms of the biomechanical characteristics, clinical application, and complications. ResultsThe treatment of intertrochanteric fractures has undergone an evolving concept from conservative treatment to surgical treatment. Surgery strategies include extramedullary fixation and intramedullary fixation. Intramedullary fixation has gradually become the main treatment of intertrochanteric fractures due to its minimally invasive and biomechanical advantages. However, the current intramedullary fixation system still can not reconstruct the medial cortical support of the proximal femur, which leads to some failures in the treatment of unstable fractures. ConclusionThe development of internal fixation of intertrochanteric fractures is based on the deep understanding and biomechanical theory of intertrochanteric fractures in clinical practice. In the future, the updated design of internal fixation devices will depend on the treatment principle of reconstruction of medial support and secondary stabilization of intertrochanteric fractures, and finally the purpose of improving success rate and reducing postoperative complications of intertrochanteric fracture will achieved.
ObjectiveTo explore the effect of a new rehabilitation intervention model based on International Classification of Functioning, Disability and Healthy (ICF) concept in perioperative treatment on patients with adolescent idiopathic scoliosis (AIS).MethodsFrom June 2017 to January 2019, AIS patients with Cobb angle below 80° were randomly divided into experimental group and control group by the method of randomized block design. The patients in the control group received routine perioperative rehabilitation intervention, while the patients in the experimental group received rehabilitation mode intervention based on ICF concept. The therapeutic effect of the two groups including functional and activity dimensions was observed.ResultsA total of 40 patients were included, with 20 in each group. Two patients withdrew the control group. On the fourth day after surgery, the total score of Modified Barthel Index (50.55±8.87 vs. 18.99±5.63; t=13.264, P<0.001) and Scoliosis Research Society-22 (SRS-22) (3.68±0.13 vs. 3.27±0.11; t=10.355, P<0.001) in the experimental group were all better than those in the control group. In the SRS-22 scores, statistically significant differences in comparison of function (2.79±0.29 vs. 1.90±0.48; t=6.884, P<0.001), and self image (3.91±0.27 vs. 3.38±0.32; t=5.539, P<0.001) between the two groups were found. There was no statistically significant difference in pain indicators and muscle strength between the two groups in the two postoperative evaluations (P>0.05). ConclusionsThe treatment based on the concept of ICF can improve the daily living ability in the short term with the safe and acceptable premise. The concept of stimulating patient autonomy, improving patient independence, and promoting social treatment, may improve the overall state of the patients.
ObjectiveTo investigate the effectiveness of the treatment under the guidance of “diamond concept” for femoral shaft fractures nonunion after intramedullary fixation.MethodsBetween January 2014 and December 2016, 21 cases of femoral shaft fractures nonunion after intramedullary fixation were treated with auxiliary plate fixation combined with autogenous iliac graft, and autologous bone marrow concentrate and platelet-rich plasma (PRP) gel under the guidance of the “diamond concept”. There were 13 males and 8 females, with an average age of 32.5 years (range, 17-48 years). All fractures were closed femoral shaft fractures. Four patients underwent internal fixation with plate and resulted in nonunion, then they were fixed with intramedullary nails, but did not heal either. The rest 17 patients were fixed with intramedullary nailing. Fracture nonunion classification: 4 cases of hypertrophic nonunion, 17 cases of atrophic nonunion; the length of bone defect was 1-3 mm; the duration from the last treatment to the current treatment was 10-23 months (mean, 14.3 months). The operation time, intraoperative blood loss, the time between operation and full loading, fracture healing time, and complications were recorded. The visual analogue scale (VAS) score and the imaging system of fracture healing of the extremities (RUST) of patients before operation and at last follow-up were recorded to evaluate the fracture healing; the function of the affected limb was evaluated according to the Schatzker-Lambert efficacy score standard at last follow-up.ResultsThe operation time was 105-160 minutes, with an average of 125.6 minutes; the intraoperative blood loss was 160-580 mL, with an average of 370.5 mL. All incisions healed by first intention, without vascular or nerve injury. All patients were followed up 22-46 months (mean, 26.5 months). All the fractures healed, with a fracture healing time of 3-7 months (mean, 4.8 months). During the follow-up, there was no infection, loosening, implant breakage, re-fracture, and other complications. The VAS score at last follow-up was 0.8±0.3, showing significant difference (t=7.235, P=0.000) when compared with preoperative score (5.2±3.7); the RUST score was 3.4±0.3, which was significantly higher than the preoperative score (1.5±0.7) (t=8.336, P=0.000). According to the Schatzker-Lambert effectiveness evaluation standard, the limb function was excellent in 16 cases, good in 4 cases, fair in 1 case, and the excellent and good rate was 95.42%.ConclusionNonunion after intramedullary fixation of femoral fracture treated with auxiliary plate combined with autogenous iliac graft, autogenous bone marrow concentration and PRP gel in accordance with the “diamond concept” can not only restore the stability of the fracture ends, but also improves the biological environment of the fracture site, and can improve the rate of fracture healing.
ObjectiveTo improve the comprehensive service ability of the hospital, improve the satisfaction of medical care, implement the requirements of fine management, and enrich the connotation of hospital internal performance improvement.MethodsIn July 2017, based on the concept of approach-deployment-learning-integration, the internal performance improvement model of Children’s Hospital Affiliated to Fudan University was constructed to form a management closed loop.ResultsFrom 2016 to 2019, the average length of hospital stay was reduced from 6.90 d to 6.47 d, the patient satisfaction was elevated from 92.89% to 93.80%, the proportion of drugs was reduced from 35.25% to 30.44%, the proportion of materials was reduced from 23.35% to 18.55%, and the proportion of difficult operations of grade Ⅲ and Ⅳ was elevated from 66.98% to 67.68%.ConclusionThe improvement of key performance indicators depends on the implementation of external policies, the integration of scientific management elements, the cooperation of multiple subjects, and the construction of information system.
Ilizarov’s technology is an internationally recognized clinical treatment method for limb orthopedics, but there are many complications related to external fixation. With the development and progress of the times, the remote-control intramedullary lengthening nails had risen to prominence on the international stage as the second generation of orthomelic technology based on Ilizarov’s technology. Since the first remote-control intramedullary lengthening nail appeared in the 1980s, after more than 40 years of development, there are currently more than 3 types of extension mechanisms in remote-control intramedullary lengthening nails and a mature and stable clinical treatment model has been formed during the past long-term clinical treatment and experiments, such as the End-Point-First (EPF) program proposed by Professor Peter H. Thaller in Germany. Compared with Ilizarov’s technology, the remote-control intramedullary lengthening nail has obvious advantages in convenience, comfort, risk of infection, soft tissue injury, postoperative pain, and controllability of limb lengthening. This article mainly introduces the development and clinical treatment concept of remote-control intramedullary lengthening nail and the latest clinical treatment status of limb lengthening therapy abroad, hoping to provide new cognition and ideas for the further development of limb orthopedics in China.
Objective To review the characteristics and deficiencies of various liposuction methods to provide reference for choosing more suitable liposuction in clinic and ideas for the improvement and development of liposuction equipment. Methods The literature related to liposuction in recent years was consulted, and the principle, indications as well as existing problems were reviewed. Results Liposuction can be divided into two categories according to the principles of fat separation. The first type relies on physical cutting to separate fat, including suction-assisted liposuction (SAL), power-assisted liposuction (PAL), and water-assisted liposuction (WAL). SAL and PAL are simple to operate and low in price, but the effect of liposuction mainly depends on the experience of the surgeon, and complications such as uneven appearance, hematoma, and ecchymosis may occur. WAL saves time and effort, but has lower cost performance. The second type relies on energy destruction to separate fat, including ultrasound-assisted liposuction, laser-assisted liposuction, and radiofrequency-assisted liposuction. This type of surgery has the advantages of less trauma, fast postoperative recovery, and skin tightening. However, the equipment is more expensive, and has a risk of skin burns. Conclusion Liposuction can effectively reduce local fat accumulation, but it still has limitations. Equipment improvement and fat transplantation are important directions for liposuction’s future development.
China is in the best period of development since modern times, and in the face of the “great changes” in the world, China’s medical and health field needs to reconstruct the medical service model actively. Under the guidance of the “Healthy China” strategy in the new era of socialism with Chinese characteristics, full life cycle health service emerged as the times require. The whole life cycle health service is based on the two focuses of the whole population and the whole life cycle, with the main characteristics of “system continuity” and “fair accessibility”, aiming to achieve the overall improvement of the health level of the whole people. This article reviews the concept, connotation and research progress of whole life cycle health service, aiming to implement the strategy of “Healthy China”, so as to provide reference for carrying out the whole life cycle health service with Chinese characteristics in the new era.
ObjectiveTo explore the predictors of seizures during pregnancy, and to explore whether seizure control in the 6 months and 1 year prior to pregnancy can predict the risk of seizures during pregnancy and the occurrence of adverse maternal and infant outcomes, so as to guide the choice of the best fertility timing for women with epilepsy (WWE).MethodsA total of 46 WWE with 48 pregnancies were enrolled in Epilepsy Clinics of Tianjin Medical University from August 2016 to January 2020. Retrospective analysis was used to analyze the risk factors of epileptic seizures in pregnancy. The patients were grouped according to the time of absence of seizures during pregnancy. To analyze the influence of epileptic seizure, pregnancy complications and pregnancy outcome.Results Among 48 pregnancies, the risk of premature rupture of membranes was significantly higher in patients with epilepsy than those without epilepsy (34.6% vs. 0.0%), and the difference was statistically significant (P<0.01). There was no significant difference in the risk of PIH, GDM, gestational anemia and pregnancy complications (P>0.05). For women who had seizure during pregnancy, the mean birth weight of the offspring was slightly lower, and the incidence of low birth weight and fetal distress was higher, but the difference was not statistically significant (P>0.05); Seizures in the 6 months before pregnancy were significantly associated with seizures during pregnancy [RR=4.28, 95%CI (2.10, 8.74), P<0.01]. Further, the risk of adverse pregnancy outcomes increased significantly [RR=2.00, 95%CI (1.10, 3.65), P<0.05] for WWE who had seizure in 6 month before pregnancy; The rates of seizures during pregnancy in the two groups were 25.0% and 20.0%, but the difference was not statistically significant (P>0.05). Compared with the 6-months, the ≥1 year group had a lower risk of PIH and gestational anemia, and the offspring had a lower risk of low birth weight, premature delivery and fetal distress, but the difference was not statistically significant (P>0.05).ConclusionEnsuring seizure-free at least 6 months before pregnancy will significantly reduce the probability of seizures during pregnancy, and is significantly associated with a lower incidence of adverse pregnancy outcomes. Women of childbearing age with epilepsy are advised to plan pregnancy after reaching seizure-free at least 6 months.