ObjectiveTo evaluate the efficacy and safety of bronchoscope in the treatment of transbronchial broncholiths.MethodsThe clinical data, treatment methods, clinical efficacy and complications of 18 patients who were diagnosed with transbronchial broncholiths were etrospectively reviewed in the Respiratory Department of the Second Hospital of Lanzhou University during January 2010 to December 2017.ResultsEighteen patients were diagnosed by bronchoscopy with a total of 22 pieces of stone for transbronchial broncholiths. An elective surgical procedure was performed in 2 cases. Six cases were treated with removing broncholiths once by foreign body forceps under bronchoscope. Repeated treatments were performed in 10 patients. Two cases underwent massive hemorrhage in the process of one-time broncholiths removal by foreign body forceps under bronchoscope, and one case suffered from bronchial fistula after the broncholiths removal, all of the above 3 patients underwent surgical treatment. All patients were followed up for 5 months without any long-term complications.ConclusionsRemoval of broncholithiasis by bronchoscopic forceps can effectively treat transbronchial broncholiths with low complication and high safety. If the broncholiths cause severe distal lung tissue injury, massive hemoptysis, bronchial fistula, or the diagnosis is unclear, surgical treatment is required. When the transbronchial broncholith is difficult to remove completely at once, batch could be chosen. First, to remove one portion which causes the obstruction of airway; and then, to remove the left part of the transbronchial broncholith by stages.
Objective To investigate the clinical effect of orthopedic robot-assisted sacroiliac joint screws in the treatment of posterior pelvic ring fractures. Methods Patients who underwent sacroiliac joint screw fixation in People’s Hospital of Deyang City between January 2018 and August 2021 were included, and the patients were divided intoa robotic group and a manual group by randomization. The robot group used robot-assisted insertion of sacroiliac joint screws, and the manual group used manual insertion of sacroiliac joint screws. The general condition, time of sacroiliac joint screw placement, intraoperative fluoroscopy times, guide needle drilling times, surgical blood loss, and Majeed pelvic function score were compared between the two groups. Results A total of 42 patients were included, and there was no significant difference in gender, age, body mass index , injury type or injury cause between the two groups (P>0.05). Finally, 21 screws were placed in 19 patients in the robotic group and 23 screws in 23 patients in the manual group. The wounds of the two groups were completely healed after operation, and there was no wound infection, iatrogenic vascular and nerve injury, and no loosening of internal fixation. There was no significant difference in screw placement time, blood loss or Majeed score between the two groups (P>0.05). The number of fluoroscopy (14.53±4.54 vs. 19.87±5.48) and drilling times (1.00±0.00 vs. 7.24±3.77) in the robotic group were less than those in the manual group, and the differences were statistically significant (P<0.05). Conclusion Orthopedic surgical robots have the advantages of minimally invasive, less fluoroscopy, and accurate screw placement in sacroiliac joint screw placement, and have good clinical results in the treatment of pelvic fractures.
Objective To systematically review literature on the influencing factors related to adolescent sub-health problems. Methods We electronically searched the following four databases including CBM, VIP, CNKI and WanFang Data to collect Chinese literature on adolescent sub-health status and problems in China published before May 2012. Two reviewers independently screened literature, extracted data, and cross checked records. Then qualitative analysis was applied. Results According to the inclusion and exclusion criteria, 41 cross-sectional studies were included. The results of qualitative analysis showed that the influencing factors of adolescent sub-health could be classified into four categories including social factors, family factors, school factors, and interpersonal relationships. The main ones were social support, employment pressure, family economic conditions, learning burden, unhealthy habits, etc. Conclusions There are many influencing factors of adolescent sub-health with interaction. Due to the limitation of the included studies, more prospective cohort studies are needed to provide high quality evidence.
Objective To assess the effect of problem-based learning (PBL) versus traditional methods in nursing students. Methods Computer retrieval was conducted to search for controlled studies comparing PBL and traditional methods. The quality of included studies was critically evaluated and data were analyzed by using The Cochrane Collaboration’s RevMan 5.0 software. Results A tota1 of 321 articles were retrieved, but only l1 were included. Metaanalyses showed that there was no significant difference between PBL and traditional methods in the objective knowledge of nursing students (SMD 0.12, 95%CI -0.32 to 0.56, P=0.6gt;0.05); but PBL was superior to traditional methods in the training of critical thinking (WMD 11.52, 95%CI 6.29 to 16.74), conflict resolution skills (WMD 8.09, 95%CI 5.02 to 11.16), clinical problem-solving skills (WMD 0.43, 95%CI 0.22 to 0.64), and communication skills (WMD 1.56, 95%CI 0.17 to 2.95). Although no significant difference was identified in the training of clinical decision-making skills, collaborative skills, and self-directed learning skills, PBL tended to be superior to traditional methods. Conclusion PBL tends are associated with better learning results among nursing students compared with traditional methods. However, most trials included in the review were of low quality, so large-scale randomized controlled trials of higher quality are needed to confirm this.
Objective
Based on images of pelvic CT three-dimensional reconstruction, to establish three-dimensional coordinate system of pelvis and investigate the three-axis displacement classification of pelvic fracture and its reduction principles.
Methods
Between June 2015 and May 2016, 21 cases of normal pelvic CT data were included in the study, and the mean pelvic three-dimensional model was established. The pelvic three-dimensional axis was established by defining the origin as the midpoint of the anterior superior iliac spine. Based on this coordinate system, a three-axis displacement classification of pelvic fracture were built. To assess the clinical guidance value of the three-axis classification, 55 cases (29 males and 26 females, aged 11-66 years with an average of 35.6 years) of pelvic fractures were analyzed by this classification, and replaced and fixed according to the principles of the reverse reduction.
Results
According to the theory of three-axis, pelvic fractures were divided into x-axis positive displacement/negative displacement, positive rotation/negative rotation; y-axis positive displacement/negative displacement, positive rotation/negative rotation; z-axis positive displacement/negative displacement, positive rotation/negative rotation. The average incision of included patients with pelvic fractures was 7.1 cm. The average reduction time was 12.2 minutes and the average radiation time was 55.3 s. The average time of screw implantation was 27.2 minutes. Postoperative pelvic X-ray films or three-dimensional CT showed all pelvic fracture was reducted well and the screw or plate was implanted correctly. The average intraoperative blood loss was 96.5 mL, the average operation time was 2.1 hours, and the average hospitalization time was 18.7 days. All patients were followed up 6-53 months (mean, 16.7 months). At last follow-up, according to Matta standard by pelvic radiography evaluation, there were excellent in 39 cases, good in 13 cases, and fair in 3 cases, the excellent and good rate was 94.55%.
Conclusion
Based on three-dimensional coordinate system, three-axis displacement classification of pelvic fracture can illustrate the displacement mode of patient simply and accurately, and can also guide the intraoperative reduction precisely.
Objective To explore the application of peer education in TB prevention at middle schools in Kai County of Chongqing and compare it with traditional education, and to provide theory support for further policy making. Methods Four complete middle schools were randomly selected as the control group, the peer education group, the traditional education group and the combined group of peer education and traditional education, respectively. Effect evaluation was performed one month later (instant evaluation) and six months later (long-term evaluation), respectively, after the intervention period. Results The instant and long-term evaluation showed that the knowledge, attitude and practice scores of the three intervention groups were higher than the scores before intervention or those of the control group (Plt;0.01). Besides, the behavior score of the peer education group had no significant difference between instant and longterm evaluation. All scores in the instant evaluation were higher than those of long-term evaluation both in the peer education group and the traditional education group (Plt;0.01). For the knowledge, attitude and practice scores, there was no significant difference between instant and long-term evaluation in the combined group of peer education and traditional education. Conclusion Compared with the peer education group and the traditional education group, the combined group achieves an enduring effect. There is obvious instant effect in the traditional education group, and peer education has a long-term influence on students’ behavior.
Objective To explore maternal health services utilization in rural areas in Rongchang County, and to analyze the influencing factors. Methods Seven hundred pregnant women were enrolled by stratified cluster sampling. The data was analyzed in SAS 8.2. Results Ninety-five percent of pregnant women had an antenatal examination, 69.3% had it for 5 times or more, and 75.4% received checking in the earlier stage of pregnancy; 98.3% were delivered in hospital, 26.3% had postpartum visit 3 times or more, and 16.7% had been systematically managed. The main influencing factors of systematic management rate were family yearly income before pregnancy whether or not the patient participated in the new rural cooperative medical scheme, and the number of pregnancies. Conclusion The maternal systematic management rate in the county has yet to be improved. Health education to improve prenatal care and postnatal visit status should be strengthened, and women should be guided to participate in the new rural cooperative medical scheme.
Objective To study the effect of surgical treatment of carpal tunnel syndrome (CTS) by endoscope through a transparent combined with dilation conductor to cut the transverse carpal l igament. Methods Between April 2003 and April 2008, 56 patients with CTS were treated with endoscopic carpal tunnel release through a transparent combined with dilation conductor. There were 8 males and 48 females with an average age of 50 years (range, 38-65 years). CTS was caused bywrist injury in 5 cases, by forearm fracture in 12 cases, and by wrist strain in 39 cases. The locations were left hand in 14 cases and right hand in 42 cases with a disease duration range of 2-7 years (4 years on average). According to Hamada classification of CTS, 38 cases were classified as stage I, 12 cases as stage II, and 6 cases as stage III. Results All cases achieved the primary heal ing of incision. All patients were followed up 14-68 months (40 months on average). According to Kelly’ s evaluation, the results were excellent in 25 cases, good in 22 cases, fair in 4 cases, and poor in 5 cases with an excellent and good rate of 83.93%. The distal motor latency of median nerve was (4.48 ± 0.50) ms at 1 months, (4.06 ± 0.35) ms at 3 months, (3.79 ± 0.25) ms at 6 months, and (3.42 ± 0.24) ms at 12 months after operation, showing significant differences when compared with the preoperative one [(5.09 ± 0.61) ms, P lt; 0.05]. There were significant differences among different time points after operation (P lt; 0.05). Conclusion The method of endoscope through a transparent combined with dilation conductor to cut the transverse carpal l igament is a simple and effective surgical procedure for treament of CTS, which can precisely cut the transverse carpal l igament and completely release the pressure of carpal tunnel.
