Objective To compare the effectiveness of open reduction and hook plate fixation versus closed indirect reduction and dorsal extension blocking Kirschner wire fixation for bony mallet fingers. Methods The clinical data of 68 patients with bony mallet finger who admitted between May 2019 and June 2022 were retrospectively analyzed. Among them, 33 cases were in the open group (treated with open reduction and hook plate fixation) and 35 cases were in the closed group (treated with closed indirect reduction and dorsal extension blocking Kirschner wire fixation). There was no significant difference between the two groups in terms of gender, age, the affected side, the affected finger, cause of injury, time from injury to operation, and Wehbé-Schneider classification (P>0.05). The operation time, intraoperative fluoroscopy frequency, fracture healing time, time of returning to work, and postoperative complications were recorded and compared between the two groups. At 12 months after operation, visual analogue scale (VAS) score was used to assess the pain of the injured finger, active flexion range of motion and extension deficit of the distal interphalangeal joint (DIP) were measured by goniometer, and the effectiveness was assessed by Crawford criteria. Results All patients in the two groups were followed up 12-26 months, with an average of 15 months. There was no significant difference in the follow-up time between the closed group and the open group (P>0.05). The operation time in the closed group was shorter than that in the open group, and the intraoperative fluoroscopy times, the fracture healing time, and the time of returning to work in the closed group were more than those in the open group, and the differences were significant (P<0.05). In the closed group, there were 5 cases of pinning tract infection and 3 cases of small area pressure ulcer skin necrosis on the dorsal side of the finger, which were cured after intensive nursing and dressing change. Local nail depression deformity occurred in 7 cases in the open group, and the deformity disappeared after removal of plate. The incisions of the other patients healed uneventfully without complications such as infection, skin necrosis, exposure of the internal fixation, or nail deformity. There was no significant difference in the incidence of skin necrosis between the two groups (P>0.05), but the differences in the incidence of infection and nail deformity between the two groups were significant (P<0.05). There was no significant difference in VAS score, DIP active flexion range of motion, DIP extension deficiency, or Crawford criteria evaluation between the two groups at 12 months after operation (P>0.05). At last follow-up, there was no DIP osteoarthritis and joint degeneration in both groups. Conclusion Open reduction and hook plate fixation versus closed indirect reduction and dorsal extension blocking Kirschner wire fixation have their own advantages and disadvantages, but both of them have good results in the treatment of bony mallet fingers. Open reduction and hook plate fixation is recommended for young patients with bony mallet fingers who are eager to return to work.
目的:研究巰基轉移酶(thioltransferase,TTase)在年齡相關性白內障患者晶狀體上皮細胞中的表達和活性,探討白內障的發病機制。方法:利用RT-PCR技術檢測白內障組和正常對照組晶狀體前囊膜下上皮細胞TTase mRNA,以β-actin為參照標化檢測指標含量,并比較各組之間TTase表達的差異。結果:RT-PCR結果顯示,白內障組晶狀體前囊膜下上皮細胞TTase mRNA表達低于正常對照組;白內障皮質組與后囊膜下組差異無顯著性,其余各組間差異有顯著性。結論:TTase在年齡相關性白內障晶狀體前囊膜下上皮細胞中有表達且比正常人低,不同臨床類型的表達不同,存在著發病機制的差異。
Objective To verify the effect of palatoplasty with or without velopharyngeal muscular reconstruction on the velar movement through the lateral radiography. Methods From October 1988 to October 2000, 62 patients with cleft palate and velopharyngeal insufficiency were treated. Of them, 32 were repaired by velopharyngeal muscular reconstruction (group A) and 30 by modified von Langenbeck’s procedure (group B). The lateral radiographs and cephalometric analysis were taken. The velopharyngeal closure, velar extensibility, the angle changes of velar elevation, the distance changes of velar levator eminence based on anatomy (LEA) to velopharyngeal closure line (VCL), the varieties in LEA, the comparison of LEA and velar levator eminence based on phonation (LEP), the distance comparison between posterior nasal spine (PNS) to LEA and LEP through soft palate line (SPL) were measured. Results During the phonation, group A was significantly greater than group B in the velopharyngeal closure rate(Plt;0.01)， the velar extensibility(Plt;0.05) and the location comparison between LEA and LEP(Plt;0.01); group B was significantly greater than group A in velar elevation angle (Plt;0.05), the varieties in LEA(Plt;0.05). In velar rest position, the distance of LEA to VCL was greater inB group than in A group(Plt;0.01). There was significant difference in thedistance comparison between LEA and LEP(Plt;0.05), difference between LEA and LEP(Plt;0.01) and the distance PNS-SPL-LEA and PNSSPL-LEP(Plt;0.05) within group B; contrary to the results within group A(P＞0.05). Conclusion The velopharyngeal muscular reconstruction in palatoplasty can result in a near normalizationof anatomic measurement of velar levator muscles and improve the velar functionand velopharyngeal competence. Repositioning of velar muscles in a more anatomic correct, transverse position is more important to improve the velar length andaccordant velar movement with velopharyngeal muscles in functional palatoplasty. The velar angle change and velar elevation during phonation are not determinative factors for velopharyngeal competence.
目的 系統評價納洛酮治療病毒性腦炎的療效與安全性。 方法 計算機檢索Medline、Cochrane圖書館、EMbase、CBM、CNKI、萬方從建庫至2012年2月收錄的相關中英文文獻，收集所有關于在抗病毒、腎上腺皮質激素以及脫水、止驚、降溫等綜合治療的基礎上，輔助應用納洛酮治療病毒性腦炎對照試驗。根據納入與排除標準篩選文獻、評價質量、提取資料，采用RevMan 5.1軟件進行Meta分析。 結果 共納入5個對照試驗，包括279例病毒性腦炎患者。Meta分析結果顯示：納洛酮的應用對13歲以上病毒性腦炎患者的總有效率[RR=1.15，95%（0.94，1.42），P=0.18]及死亡率[RR=0.45，95%（0.17，1.16），P=0.10]并無影響，但可以縮短退熱時間[WMD=?0.85，95%（?1.74，0.03），P=0.06]、頭痛消失時間[WMD=?0.40，95%（?0.55，0.25），P＜0.000 01]、抽搐停止時間[WMD=?0.87，95%（?1.09，?0.66），P＜0.000 01]、意識恢復時間[WMD=?1.10，95%（?2.05，?0.15），P=0.02]、腦膜刺激征消失時間[WMD=?0.15，95%（?0.73，0.29），P＜0.000 01]、呼衰糾正時間[WMD=?1.22，95%（?2.11，?0.33），P=0.007]及病程[WMD=?1.38，95%（?2.65，?0.11），P=0.03]。 結論 現有證據表明，納洛酮不能提高病毒性腦炎的療效，但對改善癥狀有一定幫助。受本系統評價納入研究數量和質量的限制，上述結論尚需更多高質量的隨機對照試驗驗證。
This study aims to explore whether Guzheng playing training has a positive impact on the brain functional state of children with Autism Spectrum Disorder (ASD) based on power spectral and sample entropy analyses. Eight ASD participants were selected to undergo four months of Guzheng playing training, with one month as a training cycle. Electroencephalogram (EEG) signals and behavioral data were collected for comparative analysis. The results showed that after Guzheng playing training, the relative power of the alpha band in the occipital lobe of ASD children increased, and the relative power of the theta band in the parietal lobe decreased. The differences compared with typically developing (TD) children were narrowed. Moreover, some channels exhibited a gradual increase or decrease in power with the extended training period. Meanwhile, the sample entropy parameter also showed a similar upward trend, which was consistent with the behavioral data representation. The study shows that Guzheng training can enhance the brain function of ASD patients, with better effects from longer training. Guzheng playing training could be used as a daily intervention for autism.
To investigate the immunoreaction, histological reaction and turnover by comparing the xenotransplantation of fresh human amniotic membrane (HAM) with that of preserved HAM, and to analyze the cl inical appl ication value of different kinds of HAM preparations. Methods Subcutaneous implant models were establ ished in 150 BALB/C mice, which were randomized into 5 groups of 30 mice each, based on different implants: fresh amniotic membrane (FAM), double fresh amniotic membrane (DFAM), glycerin preserved amniotic membrane (GPAM), chorion (positive control) or merely operation (negative control). The tissue samples from grafted area were observed with SABC and HE staining, and the inflammatory cells were calculated with l ight microscopy. 1, 2, 4, 8 and 12 weeks after surgery. Results The mice in all of groups were normal in eating and moving, and the wound surface healed well. In all of AM groups, the expression of MHC Ⅱ and the calculation of inflammatory cells were much less than those in chorion groups, showing significant differences (P lt; 0.01). At 1, 8 and 12 weeks after surgery, there were no significant differences in the expression of MHC Ⅱ and the calculation of inflammatory cells in all of AM groups, compared with other groups (P gt; 0.05). From 2 weeks to 4 weeks after surgery, there were no significant differences in the expression of MHC Ⅱ and the calculation of inflammatory cells between FAM and DFAM groups (P gt; 0.05), but they were both more than those in GPAM groups, showing significant differences (P lt; 0.05). At the 4th week after surgery, in all of AM groups, the expression of MHC Ⅱ and the calculation of inflammatory cells were less than those at the 2nd week, showing significant difference (P lt; 0.01).The amniotic epithel ium was still al ive in fresh AM groups until 4 weeks after transplantation. Early after surgery, fibroblasts infiltrated AM from the substantia basilaris layer while made fibrous capsule around the epithel ium. After 12 weeks, the amnion absorbed. Conclusion As a kind of heterologous biomaterial, whether fresh or preserved, HAM can be seemedof ideal immunocompatibil ity and histocompatibil ity. Fresh HAM with al ive epithel ium may be more successful in area ofrepair and reconstruction.
Objective To investigate the application and effectiveness of metatarsal mortise and tenon shortening osteotomy in the treatment of macrodactyly in children. Methods The clinical data of 17 children with macrodactyly (18 feet and 27 toes) admitted between January 2018 and January 2020 were retrospectively analyzed. There were 12 males (12 feet and 18 toes) and 5 females (6 feet and 9 toes); the age ranged from 1 to 13 years, with a median age of 5 years. All children were treated with metatarsal mortise and tenon shortening osteotomy. Ten cases of single-segment metatarsals were shortened, 7 cases of 2-segment metatarsals, and 1 case of 3-segment metatarsals; involved 1 foot of single toe, 9 feet of 2 toes, 3 feet of 3 toes, 3 feet of 4 toes, and 2 feet of 5 toes. Five cases had lameness, and 1 case had limited walking with the big toes of both feet, and there was no obvious pain in all children. X-ray films showed that the involved phalanges were thickened and increased in 18 feet, and the deformity of the distal segment was heavier than that of the proximal segment in 13 feet, and the two were similar in 5 feet. The length of metatarsal shortening was 0.7-2.5 cm, with an average of 1.2 cm. The clinical healing of shortened metatarsal fractures in children was observed after operation, and the occurrence of related complications was recorded. ResultsAll 17 children were followed up 6-22 months, with an average of 14 months. All incisions healed by first intention. The osteotomy ends of 27 toes were clinically healed after operation, and the healing time was 4-8 weeks. No nonunion, fracture displacement, malunion, epiphyseal plate premature closure, and needle tract infection occurred. ConclusionMetatarsal mortise and tenon shortening osteotomy is a good osteotomy method. It can improve the stability of the osteotomy end and increase the contact surface of the osteotomy end, which is conducive to the healing of the osteotomy end and is suitable for the treatment of macrodactyly.
Objective To evaluate the effectiveness of tibial nerve transection with epineurial suture and division of the common plantar digital nerve branches in the treatment of congenital macrodactyly in children. Methods A retrospective analysis was conducted on clinical data from 9 children with congenital macrodactyly who met the selection criteria and were admitted between January 2018 and December 2024. The cohort included 4 males and 5 females, aged 1-6 years (median, 3 years). Syndactyly of the second and third toes was present in 2 patients. Hypertrophy distribution was as follows: 1 case of single-ray involvement, 4 of double-ray, 1 of triple-ray, 1 of quadruple-ray, and 2 of quintuple-ray. Preoperatively, 7 cases exhibited limitations in both active and passive flexion and extension of the affected toes; in 2 cases, active movement was restricted while passive motion remained intact. All 9 children were unable to wear standard-sized footwear for the unaffected foot. Six presented with a limp, and 3 had difficulty walking. All 9 cases were moderate to severe progressive macrodactyly, and the growth rate of the affected foot was significantly faster than that of the healthy side. Six cases had undergone prior surgical interventions at other institutions, but disease progression continued postoperatively. All 9 patients underwent tibial nerve transection with epineurial suture and selective division of the common plantar digital nerve branches. At last follow-up, the foot growth rate was calculated (compared with that immediately after operation), and the changes of plantar pain sensation in the affected foot were detected before operation, immediately after operation, and at last follow-up, and the surgical efficacy was evaluated based on improvements in shoe fit and gait function. Results All 9 children were followed up 6-36 months, with an average of 18 months. All the incisions healed by first intention, and no infection or plantar ulceration occurred. At last follow-up, the growth rate of the affected foot was 0.10 (0.04, 0.14) cm/month, which was significantly slower than that of the healthy foot 0.14 (0.08, 0.18) cm/month (Z=3.951, P<0.001). Preoperatively, plantar pain sensation was absent in all cases; it was restored immediately after operation. At last follow-up, 6 patients had absent pain sensation, 2 had partial preservation (involving certain toes and central plantar regions), and 1 patient (with 3-year follow-up) exhibited regained sensation in multiple plantar areas. Gait improved in most cases, in which 8 children achieved normal ambulation, while 1 continued to limp due to leg-length discrepancy. Surgical efficacy were rated as excellent in 1 case, good in 7, and fair in 1. Conclusion Tibial nerve transection with epineurial suture combined with selective division of the common plantar digital nerve branches effectively reduces the growth rate of congenital macrodactyly in children, has minimal impact on plantar sensory function, and does not result in plantar ulcers or impaired ambulation.
【摘要】 目的 了解北京地區400例新型甲型H1N1流感患者的流行病學和臨床特征，總結規律，進一步指導臨床診治。 方法 2009年5-12月期間，收治400例甲型H1N1流感確診病例，主要采用描述性流行病學方法對患者資料進行回顧性分析，并運用單因素方差分析的方法對結果進行檢驗。 結果 患者以青年和兒童人群為主，47.0%的患者有明確甲型H1N1流感接觸史，主要癥狀包括發熱（98.8%）、咳嗽（85.8%）、咽痛（58.5%）。咽部充血（94.0%）和扁桃體腫大（49.5%）為主要體征。外周血白細胞正常或偏低，349例（82.3%）患者血清鐵降低，268例（72.6%）患者C反應蛋白升高。在發病后不同時間內給予奧司他韋治療的患者發熱持續時間和咽拭子的陰轉時間有顯著差異（Plt;0.001）。 結論 新型甲型H1N1流感發病多以青年和兒童人群為主，以流感樣癥狀為主，多數癥狀輕微，預后良好，C反應蛋白和血清鐵的變化可能對于早期診斷有指導價值，奧司他韋早期抗病毒治療可以縮短病程。【Abstract】 Objective To investigate the clinical and epidemiologic characteristics of pandemic influenza A (H1N1) virus infection in Beijing. Methods The epidemiological information and clinical characteristics of 400 patients with pandemic influenza A (H1N1) virus infection hospitalized in Beijing 302 Hospital from May to December, 2009 were analyzed retrospectively by descriptive epidemiology. One-way ANOVA was used to assess the results. Results H1N1 virus infection preferentially affected adolescents and young adults. The mean age of the patients was 23 years. A total of 189 (47.0%) of the patients had an identifiable epidemiologic link to another confirmed patient. The most common symptoms were fever (98.8%), cough (85.8%) and sore throat (58.5%). The main physical signs were pharyngeal portion congestion (94.0%) and antiadoncus (49.5%). The number of leukocytes in the peripheral blood was normal or low. The decreased serum iron and elevated C-reaction protein were found in 82.3% and 72.6% of the patients. There was significant difference in the duration of fever and viral shedding from throat swabs among the patients who accept the antiviral medication within the different time. Conclusion H1N1 virus infection preferentially affects adolescents and young adults, and presents with influenza-like illness. The clinical course of H1N1 virus infection is generally mild. The change of C-reaction protein and serum iron may be favorable for the diagnosis of H1N1. Early antiviral treatment may shorten the duration of fever and viral shedding.
The bionic optic nerve can mimic human visual physiology and is a future treatment for visual disorders. Photosynaptic devices could respond to light stimuli and mimic normal optic nerve function. By modifying (Poly(3,4-ethylenedioxythio-phene):poly (styrenesulfonate)) active layers with all-inorganic perovskite quantum dots, with an aqueous solution as the dielectric layer in this paper, we developed a photosynaptic device based on an organic electrochemical transistor (OECT). The optical switching response time of OECT was 3.7 s. To improve the optical response of the device, a 365 nm, 300 mW·cm?2 UV light source was used. Basic synaptic behaviors such as postsynaptic currents (0.225 mA) at a light pulse duration of 4 s and double pulse facilitation at a light pulse duration of 1 s and pulse interval of 1 s were simulated. By changing the way light stimulates, for example, by adjusting the intensity of the light pulses from 180 to 540 mW·cm?2, the duration from 1 to 20 s, and the number of light pulses from 1 to 20, the postsynaptic currents were increased by 0.350 mA, 0.420 mA, and 0.466 mA, respectively. As such, we realized the effective shift from short-term synaptic plasticity (100 s recovery of initial value) to long-term synaptic plasticity (84.3% of 250 s decay maximum). This optical synapse has a high potential for simulating the human optic nerve