Objective To investigate the value of computer-aided design (CAD) in defining the resection boundary, reconstructing the pelvis and hip in patients with pelvis tumors. Methods Between November 2006 and April 2009, 5 cases of pelvis tumors were treated surgically using CAD technology. There were 3 males and 2 females with an average age of 36.4 years (range, 24-62 years). The cause was osteosarcoma, giant cell tumor of bone, and angiosarcoma in 1 case, respectively,and chondrosarcoma in 2 cases. According to the Enneking system for staging benign and mal ignant musculoskeletal tumors, regions I, I + II, III, IV, and I + IV is in 1 case, respectively. According to the principle of reverse engineering, 5 patients with pelvis tumors were checked with lamellar CT/MRI scanning, whose two-dimensional data were obtained in disease area. The three-dimensional reconstruction of pelvic anatomical model, precise resection boundary of tumor, individual surgical template, individual prosthesis, and surgical simulation were precisely made by computer with CAD software. Based on the proposal of CAD, the bone tumor was resected accurately, and allograft il ium with internal fixation instrument or allogeneic il ium with personal ized prosthetic replacement were used to reconstruct the bone defect after tumor was resected. Results The operation was successfully performed in 5 cases. The average operation time was 7.9 hours, and the average blood loss was 3 125 mL. Hemorrhage and cerebrospinal fluid leakage occurred in 1 case, respectively, and were cured after debridement. Five patients were followed up from 24 to 50 months (mean, 34.5 months). All patients began non-weight bearing walk with double crutches at 4-6 weeks after operation, and began walk at 3-6 months after operation. Local recurrence developed in 2 patients at 18 months after operation, and resection and radiotherapy were performed. According to International Society of Limb Salvage criteria for curative effectiveness of bone tumor l imb salvage, the results were excellent in 2 and good in 3. Conclusion The individual surgical template, individual prosthesis, and surgical simulation by CAD ensure the precision and rel iabil ity of pelvis tumors resection. The CAD technology promotes pelvis tumor resection and the reconstruction of pelvis to individual treatment stage, and good curative effectiveness can be obtained.
ObjectiveTo investigate the basic situation of existing medical English teaching methods and objects, develop medical English course content and teaching methods, and evaluate teaching effectiveness. Methods The existing medical English teaching methods were summarized based on literature retrieval, and both the basic level of medical students and data related to teaching effectiveness were collected by questionnaire surveys. Results Medical English teaching could be optimized by adjusting the content of medical English teaching, increasing the proportion of English teaching, and emphasizing the application of emerging electronic products in extracurricular English learning. Teaching methods could adopt various forms such as flipped classrooms. A questionnaire survey showed that most of the students (64.94%) were not satisfied with their current English level. These students fully recognized the importance of medical English. Based on the above results, medical English courses were offered in two semesters. This course adopts theoretical lectures, small-class teaching and other teaching methods. Scenario simulation and flipped classroom were also used. Conclusion Medical English courses should include medical vocabulary, clinical medical English, vocational medical English and academic medical English. Flipped classroom and other teaching methods should be flexibly applied.
The multi-attribute utility function (MAUF) is a commonly used method for measuring health utility, characterized by a solid theoretical foundation and operational feasibility. It contributes to reducing the cognitive burden on respondents, caters to the measurement of utility across multiple dimensions, and represents another most widely applied approach beyond traditional econometrics, warranting exploration and application. However, there is currently a lack of comprehensive and systematic research on this method in China, with insufficient practical application experience. Against this backdrop, this paper aims to systematically explore the methodological background of MAUF and the key points of research design for measuring health utility using this method. By drawing on the utility measurement experiences from internationally developed measurement scales such as HUI 1, HUI 2, HUI 3, 15D, AQol-8D, ASUI, HUG-5, TOOL, and ALSUI, it systematically analyzes the critical steps in the practical implementation of the method. It is hoped that this work will comprehensively and clearly elaborate on the practical approaches of MAUF, promote the further development of MAUF in China, and provide methodological references for future studies on health utility measurement based on MAUF.
Due to the competition of new drug research and clinical requirement, speeding up drug development and marketing requires faster and more flexible clinical trial design that meets the ethical requirements. Different adaptive designs have emerged in clinical trials of different stages and purposes, for trial efficiency improvement. Adaptive design is more widely used in the field of oncology. Compared with traditional design, adaptive design is more complicated and requires higher level of methodology from researchers. Therefore, implementing adaptive design requires careful consideration and adequate preparation. This paper aims to summarize the design of adaptive methods used in different trial stages so as to provide reference for clinical research designers and implementers.
ObjectTo observe the clinical efficacy and safety of the combination therapy of atorvastatin and JiangZhi Decoction (ZJD) for primary hyperlipidemia (Tan Zhuo Zu E Zheng) and to analyze the interactions of drugs in hypolipidemic effect. MethodsA 2*2 factorial design, single-blind, stratified randomized controlled trial according to the level of lipid was conducted. Primary hyperlipidemia (Tan Zhuo Zu E Zheng) patients met the inclusion criteria were divided into 5 groups:ATV 10 mg group (group A), ATV 20 mg group (group B), ATV 10 mg+JZD group (group C), ATV 20 mg+JZD group (group D), JZD group (group E). After two weeks treatment, the efficacy and safety among the 5 groups were compared. ResultsA total of 92 patients were included, of which, 20 were in group A, 25 in group B, 21 in group C, 17 in group D, and 9 in group E. The results showed that:(1) There was no significant difference between group C and group B in the reduction of serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) (PTC=0.226, PLDL-C=0.818). (2) The results of 2*2 factorial analysis showed that, there was no significant interaction between TCM factor and western medicine factor (PTC=0.605, PLDL-C=0.843). (3) There were no significant differences in safety outcomes among 5 groups (all P values >0.05). ConclusionATV 10 mg+JZD and ATV 20 mg have a similar efficacy in reducing TC and LDL-C. There is no obvious interaction between JZD and ATV in hypolipidemic effect, and the combination therapy of ATV and JZD is safe.
Objective To evaluate the quality of clinical studies on dentistry from the Chinese Journals. Methods Clinical studies in Chinese Journal of Conservative Dentistry of 2002 were searched. The quality of the clinical studies on assessment of treatments’ efficacy was evaluated. Results Among 204 related studies from 12 issues, there were 93 (45.58%) restrospective intervention studies, 6 randomized controlled blinded trials (2.94%), 42 randomized trials without blindness (20.58%), 20 controlled trials without randomization (9.80%) and 25 clinical observational studies (12.25%). The statistical analysis showed that 20 studies were with inappropriate methods. Conclusions It is necessary to improve the design and statistical analysis of clinical studies on stomatology in China to produce high-quality research evidence.
ObjectiveTo introduce a modified technique of a sloped skin island design for the distally based sural nuerofasciocutaneous flap to reconstruct soft tissue defects longitudinal in distal pretibial region or transverse in the heel and ankle, and report the effectiveness of the modified technique. MethodsBetween April 2001 and January 2016, 37 patients (38 defects) with longitudinal defects in distal pretibial region or transverse defects in the heel and ankle were treated with the sural nuerofasciocutaneous flap with slope-designed skin island. These patients included 28 males and 9 females, with a median age of 37 years (range, 5-78 years). The horizontal and vertical dimensions ranged from 3 to 8 cm and 8.5 to 14.5 cm in 11 distal pretibial defects, and from 9 to 21 cm and 3.0 to 10.5 cm in 27 heel and ankle defects, respectively. The disease duration ranged from 2 days to 5 years. ResultsWhen the skin islands were routinely designed, the skin islands of 25 flaps would exceed the lateral limit (the anterior border of the fibula) laterally or medial limit (the medial border of the tibia) medially. After the skin islands were obliquely designed, the horizontal dimensions in 38 flaps decreased an average of 5.4 cm (range, 2.5 to 14.8 cm), and the vertical dimensions increased an average of 5.3 cm (range, 2 to 15 cm). The rotation angles ranged from 42° to 90°, with an average of 67°. Thirty-five flaps survived uneventfully. Margin necrosis occurred in 2 flaps, and partial necrosis in 1 (2.6%) flap. The grafted skins at donor site survived, and primary healing of incision was obtained. All patients were followed up 6 to 42 months (mean, 10 months). No infection or ulceration was noted during the follow-up period, and the appearances of the flaps were satisfactory. At last follow-up, according to Boyden et al criteria, the limb function was excellent in 30 cases, good in 6 cases, and poor in 2 cases, with the excellent and good rateof 94.7%. ConclusionWhen the distal sural nuerofasciocutaneous flap is used to reconstruct soft tissue defects longitudinal in distal pretibial region or transverse in the heel and ankle, the modified technique of sloped skin island design can decrease the horizontal dimension of the skin island, improve the flap survival rate, and extend its indications.
In order to promote the effective development of hospital day surgery mode, a construction method of information management platform that meets the characteristics of day surgery mode is presented. By analyzing the business process of the day surgery mode, the system architecture of the information platform is given; according to the difficulty of the surgical scheduling, the two-stage surgical scheduling algorithm based on the ranking theory is given; by analyzing the day surgery data statistically, a multi-angle surgical index analysis module is provided. The information management of the day surgery mode has been realized, and the work efficiency has been improved. A reasonable day surgery information platform construction can help to optimize the daytime surgical procedure and promote the smooth development of day surgery.
Brain-computer interface (BCI) is a revolutionizing human-computer Interaction, which is developing towards the direction of intelligent brain-computer interaction and brain-computer intelligent integration. However, the practical application of BCI is facing great challenges. The maturity of BCI technology has not yet reached the needs of users. The traditional design method of BCI needs to be improved. It is necessary to pay attention to BCI human factors engineering, which plays an important role in narrowing the gap between research and practical application, but it has not attracted enough attention and has not been specifically discussed in depth. Aiming at BCI human factors engineering, this article expounds the design requirements (from users), design ideas, objectives and methods, as well as evaluation indexes of BCI with the human-centred-design. BCI human factors engineering is expected to make BCI system design under different use conditions more in line with human characteristics, abilities and needs, improve the user satisfaction of BCI system, enhance the user experience of BCI system, improve the intelligence of BCI, and make BCI move towards practical application.
ObjectiveTo explore the method and feasibility of digital internal fixation for proximal tibia fractures using standard parts database and three-dimensional (3D) printing technology. MethodsTen adult lower extremity specimens were selected to take continuously thin-layer scanning. After Dicom image was imported into the Mimics software, the model of Schatzker Ⅱ-VI types proximal tibia fracture was established, 2 cases each type. The virtual internal fixation was performed with plate and screw from standard parts database. The pilot hole of the navigation module design was printed by 3D printing technique. The plate and screw were inserted by the navigation module. X-ray film and CT were taken postoperatively to observe the position. Thirty patients with proximal tibia fracture underwent digital internal fixation using standard parts database and 3D printing technology (study group), and another 30 patients underwent traditional open reduction and internal fixation (control group). There was no significant difference in sex, age, side, causes, fracture classification, associated injury, and course of disease between 2 groups (P>0.05). The preparative time, incision length, fracture healing time, operation time, and intraoperative blood loss were recorded. Follow up of imaging evaluation, clinical efficacy was evaluated by MacNab criteria. ResultsThe navigation models were designed to fit the bony structure of proximal tibia and to guide implant insertion. The parameters of orientation, length, diameter, and angle were consistent with the preoperative plan. No statistically significant difference was found in the preparative times of pre-operation between 2 groups (t=1.393, P=0.169). The incision length, wound healing time, blood loss, operation time, and the cost of treatment in study group were significantly less than those in control group (P<0.05). All patients were followed up 12-16 months (mean, 13.5 months). The fracture healing time of study group was significantly shorter than that of control group (t=4.070, P=0.000). At 12 months postoperatively, there was no significant difference in the efficacy based on MacNab criteria between 2 groups (U=377.000, P=0.238). ConclusionDigital internal fixation for proximal tibia fractures using standard parts database and 3D printing technology has the advantages of short process, less blood loss, high safety and rapid fracture healing.