Objective To explore the effect of the collateral ligaments and the plantar plate on the flexion of the metatarsophalangeal(MP) joints. Methods Twenty-four preserved human No.2-4 digits were obtained from embalmed cadaver feet, which were divided into 2 groups at random. In group A, the bilateral collateral ligaments were cut first, and then the plantar plate was sectioned. They were cut inopposite sequence in group B. Angle of the flexion of MP joint was observed in the same load after the bilateral collateral ligaments and the plantar plate were sectioned in different sequence.From 1994 to 2000,11 cases were used with this technic, including plantar section in 2 cases and both plantar section and bilateral collateral ligamentscut in 9 cases. Results The angle of flexion of the MP joint before operation in group A is 37.30±5.42°, it increased 11.29±2.36° and to 48.60±2.98° when the bilateral collateral ligaments were cut, and there was significant difference. Later the cut of the plantar plate increased another 5.30±1.59° and to 53.35±2.76°. Both have an increasing trend for the angle of flexion of the MP joint (Plt;0.01). While in group B, the angle of flexion of the MP joint before operation is 34.59±5.32°, it increased 6.29±2.98° and to 40.89±2.36° when the plantar plate were cut, laterthe cut of the bilateral collateral ligaments increased another 9.71±1.94° and to 50.60±2.01°. Both had an increasing trend for the angle of flexion ofthe MP joint (Plt;0.01). The bilateral collateral ligaments had more influence than the plantar plate (Plt;0.01). There was the same effect in different sequence (Pgt;0.05). In 2 cases with plantar section, the flexion angle of MP joint could achieve 15° to 45° in 2 monthes. The other 9 cases with both plantar section and bilateral collateral ligaments cut, the MP joint flexion achieved 10.3° to 58.4° in 26.3 months. Conclusion The flexion angle of the MP joint can be increasedby cutting the bilateral collateral ligaments and the plantar plate.
As a major disease that seriously endangers the health of Chinese residents, stroke has various triggering factors, among which infection is one of the initial factors. Previous studies have indicated a correlation of common oral infectious diseases such as periodontitis with the occurrence of stroke. However, there is a lack of effective integration of previous research on the induction of stroke by common oral infectious diseases. This article provides a comprehensive review of the relevant research on infectious diseases and stroke, with a particular focus on the progress related to periodontitis, gingivitis, dental caries, and pulpitis as triggers for stroke. It puts forward relevant recommendations for promoting oral health, so as to provide a theoretical basis for improving oral health literacy of Chinese residents and reducing the incidence of stroke and other major diseases.
ObjectiveTo determine the effects of the management mode participated by doctors, nurses and patients on the safety of medical tubes for restlessness patients in the Neurosurgery Intensive Care Unit (NICU). MethodsA total of 133 restlessness patients treated between May 17 and November 22, 2013 were included in the study as control group, who were admitted to the NICU before application of the management mode participated by doctors, nurses and patients; another 119 restlessness patients treated between May 17 and November 22, 2014 were included in the study as research group, who were admitted to the NICU after application of the management mode participated by doctors, nurses and patients. Then we compared the accidental extubation situation between the two groups. ResultsThe accidental extubation rate of all kinds of medical tubes in the research group was lower than that in the control group, among which the extubation rate of urethral catheter (0.67% vs. 4.32%), gastric tube (2.26% vs. 10.14%), trachea cannula (1.08% vs. 7.84%), and arterial cannulation pipeline (1.12% vs. 6.93%) was significantly different between the two groups (P<0.05). ConclusionThe management mode participated by doctors, nurses and patients can effectively reduce the accidental extubation rate of medical tubes for restlessness patients, prevent the occurrence of adverse events and ensure the treatment and nursing safety in the NICU.
ObjectiveTo understand the effect of programmed death-1 (PD-1) inhibitors on defective mismatch repair (dMMR) / microsatellite instability-high (MSI-H) advanced colorectal cancer (CRC). MethodThe literature of recent research relevant PD-1 inhibitors in the utility for patients with dMMR/MSI-H advanced CRC was reviewed and summarized. ResultsAt present, there were many studies exploring the utility of anti-PD-1 inhibitors for the treatment of dMMR/MSI-H advanced CRC (including locally advanced CRC and metastatic CRC), and some studies were still in trials. Studies had consistently shown that the use of PD-1 inhibitors in dMMR/MSI-H advanced CRC as first-line or subsequent therapy, as well as in the neoadjuvant setting, leading to significant survival benefits. These benefits were particularly notable in cases of dMMR/MSI-H metastatic CRC with concurrent BRAF/RAS mutations and in the context of neoadjuvant immunotherapy aimed at organ preservation in locally advanced dMMR/MSI-H CRC. Moreover, there were numerous studies exploring “dual immunotherapy”, and most studies found that its efficacy was superior to that of single immunotherapy. However, the more adverse events were reported by the “dual immunotherapy” compared to the single immunotherapy. ConclusionsOverall, based on results of the literature reviewed, PD-1 inhibitors have shown significant clinical benefits in dMMR/MSI-H advanced CRC, but there are still more issues that need to be further explored, such as discovering more first-line PD-1 inhibitors, overcoming drug resistance and adverse events. Future clinical practice should prioritize more precise individualized identification and the application of more effective combination therapy regimens to further optimize outcomes for patients with dMMR/MSI-H advanced CRC.
Periodontal disease is a common chronic infectious disease targeting the connective tissue supporting the dentition. In recent years, the research on periodontal disease and cerebral infarction has been increasing. However, the causal relationship between periodontal disease and cerebral infarction remains unclear. Periodontal disease may be associated with atherosclerosis, which is one of the major causes of cerebral infarction. Regular dental care can reduce the risk of cardiovascular disease. Therefore, investigating the above association and its underlying mechanisms is of great clinical significance, which may help clinicians to make appropriate treatment and prevention measures. In this paper, the research progress and possible mechanism of the relationship between periodontal disease and cerebral infarction were reviewed.
Ischemic stroke can lead to disruption in the oral ecology and an overgrowth of pathogenic bacteria, resulting in periodontal disease. Meanwhile, the aspiration and pulmonary infection resulted from dysphagia can increase the unfavorable prognosis. Some studies have found that there exist oral bacteria in the thrombus in myocardial infarction and ischemic stroke patients, showing that oral flora might be associated with thrombus and stroke-associated pneumonia. There are few high quality clinical studies or evidence-based guidelines. Priority should be given to high quality research that provides oral care standards, and incorporating oral care into future stroke pathways to improve the prognosis.
背景 隨機對照試驗（randomized controlled trials，RCTs）常用于評估社會和心理干預措施的效果，這些結果亦常被用于制定決策。有關社會及心理干預措施試驗結果的準確、完整和透明的報告，對了解針對這些干預措施的臨床試驗設計、實施、結果及這些結果的應用至關重要。然而，關于社會和心理干預措施的 RCT 報告質量仍不理想。CONSORT（consolidated standards of reporting trials）聲明改善了生物醫學領域 RCT 的報告質量，同樣，行為和社會科學方面也需要類似的高質量報告規范。我們的目標是基于 RCT 報告規范 2010 年聲明（Consolidated Standards of Reporting Trials 2010 Statement，CONSORT 2010）的官方擴展版，制定適用于社會和心理干預措施（social and psychological interventions，SPI）的 RCT 報告規范（CONSORT-SPI 2018）。 方法 我們遵循最佳方案制定報告規范的擴展版。首先，我們對現有報告規范進行了系統評價。隨后，我們進行了有 384 位國際參與者參加的德爾菲在線調查。2014 年 3 月，我們舉行了為期 3 天的共識會議，由 31 位專家參與，確定針對社會和心理干預措施的 RCT 報告的檢查清單內容。專家們仔細討論了先前與社會和心理干預措施 RCT 相關的研究和方法學問題。然后，投票決定對 CONSORT 2010 條目的修改或擴展。 結果 CONSORT-SPI 2018 檢查清單擴展了 CONSORT 2010 的 25 個條目中的 9 個，包括：背景和目標、試驗設計、受試者、干預措施、統計方法、受試者流程、基線數據、結果和估計及資助來源。此外，與會者還添加了一個與利益相關方參與度有關的新條目，此外，也修改了與受試者招募和及其后續維持相關的流程圖。 結論 作者應使用 CONSORT-SPI 2018 來改善社會和心理干預相關的 RCT 的報告質量。期刊應修改編輯政策和程序，要求作者使用報告規范準備相關稿件，要求同行評議者使用報告規范評審相關稿件，以使讀者能夠評估研究的質量，評價研究結果的推廣性，并重復有效的干預措施。
Objective To understand the influence of organisational support and professional identity of hospital infection prevention and control (HIPC) practitioner in public hospitals. Methods HIPC practitioner of the public medical institutions secondary level and above in Neijiang City, Sichuan Province were used as the research object. A questionnaire survey was used to analyze their organizational support and professional identity in May 2022, to compare the differences in organizational support and professional identity among HIPC practitioner with different positions, working ages, and majors, and analyze the correlation between organizational support and professional identity among HIPC practitioner. Results A total of 90 valid questionnaires were retrieved from investigation. The average scores for organizational support and professional identity among HIPC practitioner were (3.409±0.625) and (2.518±0.504) points. Among them, the organizational support of intermediate professional title personnel [(3.155±0.785) points], personnel with 5-10 years of service [(3.071±0.696) points], and clinical physicians [(3.342±0.860) points] were the lowest; the professional identity of personnel with intermediate professional titles [(2.357±0.477) points], those with more than 10 years of service[(2.431±0.454) points], and other professionals [(2.471±0.260) points] were the lowest. The Pearson correlation analysis results showed that there was a positive correlation between organizational support and professional identity (r=0.490, P<0.05), self-identity and work support (r=0.364, P<0.05), and environmental identity and relationship interests (r=0.698, P<0.05). Conclusions Due to the low level of organizational support, there is a decrease in professional identity and significant job burnout, which in turn leads to an increase in the turnover rate of infection control professionals. Therefore, it is necessary to enhance the sense of organizational support for specialized personnel in infection control to promote their professional identity and stabilize the infection control team. Suggest providing necessary support at the organizational level and self-improvement at the individual level.
【Abstract】 Objective To evaluate the early result of tri ple Endobutton technique for reconstructing coracoclavicularligament of chronic complete acromioclavicular joint dislocations. Methods Between January 2009 and June 2010, 14 patients with chronic complete acromioclavicular joint dislocations were treated with tri ple Endobutton technique for reconstructing coracoclavicular ligament. There were 10 males and 4 females with a mean age of 38.5 years (range,26-52 years). Injury was caused by traffic accident in 7 cases,by falling in 5 cases，and by bruise in 2 cases. The average time was 47 days from injury to the operation (range,29-75 days). All patients had pain and activity restriction. The X-ray films showed complete dislocation of acromioclavicular joint. According to Allman’s type, all cases were classified as III degree complete dislocations. Results At postoperation, wound healed by first intention with no early complication of infection or neurovascular injury. All patients were followed up 18.3 months on average (range,13-30 months). Acromioclavicular joint subluxation occurred in 1 patient at 1 week after operation, and no redislocation or other complication occurred in the other patients. American Shoulder and Elbow Surgeons (ASES) score was 90.8 ± 4.1 at last follow-up, showing significant difference when compared with the preoperative score (65.3 ± 4.4) (t= —17.57，P=0.00); Constant-Murley score was 91.7 ± 3.9, showing significant difference when compared with preoperative one (71.5 ± 4.6) (t=—75.02，P=0.00). The definite answer in Simple Shoulder Test (SST) averaged 9.7 (range,7-12). Conclusion The tri ple Endobutton technique for reconstructing coracoclavicular ligament is an effective method in treatment of chronic complete acromioclavicular joint dislocations. The short-term results are satisfactory.
背景 研發隨機對照試驗報告規范 CONSORT 聲明旨在幫助生物醫學研究人員透明地報告隨機對照試驗（randomised controlled trials，RCTs）。我們已針對社會和心理干預措施制定了 CONSORT 2010 聲明擴展版（CONSORT-SPI 2018），以幫助行為和社會科學家透明地報告這些研究。 方法 在對現有報告規范進行系統評價之后，我們進行了在線德爾菲流程（Delphi process）以優先考慮從系統評價中確定的 CONSORT-SPI 2018 清單的潛在條目。384 位國際參與者中有 321 位（84%）完成了 2 次調查。然后我們召開了由 31 位科學家、期刊編輯和研究資助者組成的共識會議（2014 年 3 月），最終確定 CONSORT-SPI 2018 檢查清單和流程圖的內容。 結果 CONSORT-SPI 2018 擴展了 CONSORT 2010 檢查清單中的 9 個條目（包括亞條目在內的 14 個條目），增加了一個與利益相關方參與試驗有關的新條目（包括 3 個亞條目），并修改了 CONSORT 2010 流程圖。本解釋與說明（E&E）文件是 CONSORT-SPI 2018 的用戶手冊，可幫助使用者更好地理解 CONSORT-SPI 2018。本文討論了每個清單條目的含義和原理，并提供了完整及明晰的報告示例。 結論 CONSORT-SPI 2018 擴展版、解釋與說明文件及 CONSORT 網站（www.consort-statement.org）是有助于改善社會和心理干預措施 RCTs 報告的有用資源。