Objective To investigate the effectiveness of double-needle suture for mixed meniscus tear repair under arthroscope. Methods Between April 2006 and January 2011, 22 patients with mixed meniscus tear were treated with double-needle suture under arthroscope. There were 14 males and 8 females, aged 18-41 years (mean, 31.3 years). All injuries were caused by sports. The time between injury and admission ranged from 2 days to 4 years (median, 11 months). International Knee Documentation Committee (IKDC) score was 42.5 ± 15.2, Lysholm score was 45.5 ± 13.5, and Tegner score was 2.9 ± 1.6. Seventeen cases complicated with anterior cruciate ligament injury. Results Healing of incision by first intention was achieved in all patients. No injury of nerve and blood occurred. The patients were followed up 12-48 months with an average of 27.6 months. According to Barrett et al. standard, 19 cases (86%) got clinical healing. The IKDC, Lysholm, and Tegner scores were improved to 77.1 ± 8.9, 79.8 ± 9.9, and 6.8 ± 1.6 respectively at last follow-up, showing significant differences when compared with preoperative scores (P lt; 0.05). Conclusion Arthroscopic meniscus repair using double-needle suture can provide good effectiveness because it has high firmness.
OBJECTIVE To investigate the mechanism of electrothrombosis by copper needle, in order to supply the referential data for clinical treatment of vessel deformity. METHODS The mechanism and condition of thrombus formation by copper needle were studied in vivo and in vitro using electrophysics, atom absorption spectrophtometry, histological, and histochemical methods. RESULTS Great deal of copper ion was dissociated, and agglutination of red blood cells(RBC) in blood could be observed in vitro after the current applied by copper needles. Formation of stable thrombus was related to voltage and time of application of electric current. CONCLUSION Dissociation of copper ion and agglutination of RBC are the basic principle of electrothrombosis with copper needle. A 4V direct current and 17.5 minutes are the safe and effective conditions for thrombus formation in the blood vessels.
Objective To investigate the effectiveness of three-needle and two-cable structure in the treatment of inferior patellar pole avulsion fractures. Methods A clinical data of 62 patients with inferior patellar pole avulsion fractures who were admitted between January 2023 and December 2023 and met the selection criteria was retrospectively analyzed. Among them, the fractures were fixed with three-needle and two-cable structure in 32 patients (observation group) and traditional steel wire tension band in 30 cases (control group). There was no significant difference in the baseline data of age, gender, side of the affected limb, cause of injury, and disease duration between the two groups (P>0.05). The operation time, fracture healing and healing time, patellar height (Insall-Salvati index), occurrence of complications, knee range of motion, and Böstman score at last follow-up were compared between the two groups. Results The operation time of the observation group was significantly shorter than that of the control group (P<0.05). Patients in both groups were followed up 6-12 months (mean, 10.4 months). X-ray films re-examination showed that all fractures healed, and the fracture healing time was significantly shorter in observation group than in control group (P<0.05); no significant difference was found in Insall-Salvati index between the two groups (P>0.05). During follow-up, the complications occurred in 2 cases (6.25%) of observation group and in 9 cases (30.00%) of control group, and the difference in the incidences between the two groups was significant (P<0.05). At last follow-up, the range of motion and Böstman score of the knee joint in observation group were significantly superior to control group (P<0.05). Conclusion Compared with the traditional steel wire tension band fixation, the three-needle and two-cable structure fixation of the inferior patellar pole avulsion fractures is firm, which allows the knee joint to move early after operation and is conducive to the recovery of knee joint function.
Objective To explore the effect of community-hospital continuous nursing on the satisfaction of day surgery patients in terms of their nursing needs. Methods Sixty patients hospitalized in the day surgery ward in our hospital from April 2014 to March 2015 were enrolled in this study. According to the order of admission, they were divided into control group and observation group with 30 patients in each. Patients in the control group were given health guidance, while those in the observation group were given continuous nursing. Questionnaire survey was conducted in both the two groups. The nursing needs of patients after surgery were summarized, and the satisfaction of patients’ nursing needs through different nursing methods were analyzed. Quality of life questionnaire-C30 was used to evaluate the quality of life of the two groups of patients one month and three months after surgery, and the incidence of postoperative complications of the two groups was statistically analyzed. The changes of daily life ability of patients one month and three months after surgery were evaluated by the modified PAP index. Results Day surgery patients had a high demand for postoperative incision care, dressing change, postoperative medication, dietary guidance, postoperative guidance, health education and other aspects of health care needs. There was little demand for oral pipeline care and physical therapy. The satisfaction rate of patients in the observation group toward n ursing service (96.7%) was significantly higher than that in the control group (66.7%) (P < 0.05). The incidence of postoperative wound bleeding, poor healing, infection, urinary retention and other complications in the observation group was lower than those in the control group, but only the difference in the incidence of infection was statistically significant (P < 0.05). One month and three months after surgery, the quality of life in the observation group was significantly better than that in the control group (P < 0.05). The complete self-care ratio in the observation group was higher than that in the control group, and the proportion of slight defect in the observation group was lower than that of the control group (P < 0.05). Conclusion Continuous community-hospital nursing can improve the satisfaction of patients toward nursing service, promote patients’ quality of life, and facilitate patients’ recovery after surgery.
Objective To find a simple, practical and cheap way in suturation to prevent incision complications after celoscope surgery. Methods Using the elastic snell needle to stitch small incision under laparoscopy. Chosed 3 120 cases using the elastic snell needle to stitch stratified suturation as research group, and 3 120 cases by using trditional arc shaped needle in celoscope surgery as control group. The incident rate of incisional hernia and incision bleeding among groups were compared. Results In research group, the incident rate of incision bleeding was 0.16%, among which was 0.15% in epigastrium group, 0.18% in hypogastrium group, while in control group, the incident rate of incision bleeding was 0.68%, among which was 0.64% in epigastrium group, 0.70% in hypogastrium group. The incident rate of incision bleeding was obviously decreased (P＜0.05), and the incident rate of incision bleeding in hypogastrium group was obviously decreased as well (P＜0.05), compared research group and control group. In research group, the incident rate of incisional hernia was 0.07%, among which was 0 in epigastrium group, 0.12% in hypogastrium group, 0.15% in gerontism group, while in control group, the incident rate of incisional hernia was 0.44%, among which was 0.24% in epigastrium group, 0.59% in hypogastrium group, 0.99% in gerontism group, and the incident rate of incisional hernia after surgery was obviously decreased (P＜0.05), the incident rate of incisional hernia after surgery in hypogastrium group was obviously decreased as well (P＜0.05), comparing research group and control group. Conclusions Using the elastic snell needle to stitch small incision under laparoscopy, the peritoneal layer and muscular layer can be apposition sutured in the case without prolonging incision and costing more, hidden hernia and abdominal wall defects located at the incision can be found, ligation and stitched, thereby the incident rate of incisional hernia and incisional bleeding after celoscope surgery are significantly reduced.
Objective To report our experience in using The Bethesda System for Reporting Thyroid Cytopathology(TBSRTC), and to investigate the diagnostic value of the system based on the cytologic-histologic result. Methods Pathological data of 2 257 thyroid nodules classified by TBSRTC which were obtained from the Department of Pathology of West China Hospital between Jan.2010 to Dec.2012 were collected and analyzed, to investigate the diagnostic evaluation indicators, such as the sensitivity, specificity, and diagnostic accuracy of the system based on the cytologic-histologic result. Results Of the 2 257 thyroid nodules, 442 (19.6%) were diagnosed as categoryⅠ, 1 184(52.4%) were diagnosed as categoryⅡ, 216(9.6%) were diagnosed as categoryⅢ, 38(1.7%) were diagnosed as categoryⅣ, 172(7.6%) were diagnosed as categoryⅤ, 205(9.1%) were diagnosed as categoryⅥ. Using TBSRTC categoryⅡas the boundary point of diagnosing benign and malignant diseases, the sensitivity, specificity, and diagnostic accuracy were 93.7%(236/252), 86.6%(323/373), and 89.4%(559/625)respectively, while categoryⅢwas excluded from analysis. When including categoryⅢinto analysis, the sensitivity, specificity, and diagnostic accuracy were 94.3%(267/283), 74.9%(323/431), and 82.6%(590/714)respectively. Conclusion The validity of TBSRTC was high at our institution. TBSRTC has proven to be an accurate and reliable approach for the diagnosis of thyroid nodules.
Objective To define the attributes and priorities of evidence-based nursing curriculum needs of nursing students, so as to provide operational reference for the design and development of evidence-based nursing course in the future. Methods Questionnaire was designed based on Kano model, and convenient sampling method was adopted to investigate the nursing students who had received training or had experience in evidence-based nursing from September to November 2020. According to the Kano model attribute classification method, the need attribute of evidence-based nursing curriculum was defined. Results A total of 303 nursing students were investigated. Kano model analysis showed that 11 of the needs for evidence-based nursing courses were one-dimensional quality, which belonged to the dimension of teaching resources and teaching content, and 5 were indifference quality, which belonged to the course assessment dimension. The importance-satisfaction matrix showed that the need of evidence-based nursing curriculum was concentrated in the advantage area and minor excepting improvement area. Conclusions In the future curriculum design, evidence-based nursing teachers need to continue to maintain the demand items in the advantage area and constantly improve and perfect them. They also need to pay more attention to the demand items in the minor excepting improvement area. Combined with the current problems in evidence-based nursing practice and the evidence-based needs of students, teachers need to further put forward suggestions on evidence-based nursing curriculum.
According to the working principle of vertical ultrasonic vial washing machine, receiving respective force of small water droplets on the inside wall of vials and the minimum air velocity of blowing off water droplets can be obtained based on the analysis of water-droplet-related parameters. The inside wall model of 7 mL vial created by GAMBIT was divided into fine grids. Then the Realizable k-epsilon Two Equation Turbulence Model was adopted and the flow field of vial by FLUENT software was simulated when air was flushing inside the wall. In that case, the optimal position, inner diameter and the corresponding minimum air velocity of needle can be acquired to meet the needs of vial washing machine applied to 7 mL vial.
Objective To explore the changes in the serum Cu2+and the indexes for the liver pathology and biochemistry before and after the copper needle retained in the central veins of the rabbit ears. Methods Fortynine New Zealandrabbits were randomly divided into 5 groups: Group A (copper needles retained for 1 d), Group B (3 d), Group C (5 d), Group D (7 d), and Group E (the control group, without any copper needles retained). In each experimental group, there were 10 rabbits, and in the control group there were 9 rabbits. The rabbits in each group were arranged to have their venous blood drawn for determination of theCu2+concentration, and for observation on the changes in the liver biochemicalindexes for 5 times before and after the copper needles were retained in the central veins of the rabbit ears. At the same time, a piece of the liver tissue ineach rabbit was taken for examination of the pathological changes. All the liver samples were given the basic pathological examination; if the liver sample hadsome extraordinary pathological features, the specific pathological examinationwould be given, even using the transmission electron microscope. Results After the copper needles were retained in the central veins of the rabbit ears, the Cu2+concentration increased with the passing time. The concentrations in the groups were 1.40±0.49 μg/ml in Group A, 1.45±0.53 μg/ml in Group B, 2.01±0.40 μg/ml in Group C, 2.38±0.83 μg/ml in Group D, and 1.34±0.45 μg/mlin Group E, respectively. There was a statistically significant difference between Group D and Group E(P＜0.05). There were no significant changes in the ALT and AST levels when compared with those before the copper needles were retained(P＞0.05); however, there was a considerably positive correlation on 1st day (r=0.686, P＜0.05), 5th day (r=0.712, P＜0.05), and 7th day (r=0.768, P＜0.01) when compared with those after the copper needles were retained. The histological examination showed that aseptic inflammation subsided with the time in part of the liver. The Masson staining and the Ag staining showed that there were no obvious changes in the hepatic lobules, with no fibrosis of the liver tissues found under light microscope. Conclusion There are no obvious toxic and side effects on the rabbit liver after the copper needles are retained in its central veins.
Objective To review and summarize the development during the last 20 years and the current status of cosmetic medicine, i.e., cosmetic surgery, in China, for the healthier development of this specialty inthe future. Methods Literature concerned was reviewed, including conferenceabstracts, papers, and publications, and the present status and problems were analyzed. Results Cosmetic medicine was recognized as an independent specialty and gained its clear definition. The development of cosmetic medicine is an inevitable trend of the changing medical modules and the developingscience and civilization. This trend fulfilled the need of the people. The related problems consisted of a high complication rate, confusion of management, andinsufficient specific knowledge in part of the providers. Conclusion The development of cosmetic medicine is an inevitable trend of the civilization development. For the healthy development of this specialty, scientific management and systemic education for the providers are crucial. Only those who have the plastic surgery background are able to participate in this practice.