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.
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.
The study aimed to evaluate the therapeutic effect of nilotinib-loaded biocompatible gelatin methacryloyl (GelMA) microneedles patch on cardiac dysfunction after myocardial infarction(MI), and provide a new clinical perspective of myocardial fibrosis therapies. The GelMA microneedles patches were attached to the epicardial surface of the infarct and peri-infarct zone in order to deliver the anti-fibrosis drug nilotinib on the 10th day after MI, when the scar had matured. Cardiac function and left ventricular remodeling were assessed by such as echocardiography, BNP (brain natriuretic peptide) and the heart weight/body weight ratio (HW/BW). Myocardial hypertrophy and fibrosis were examined by WGA (wheat germ agglutinin) staining, HE (hematoxylin-eosin staining) staining and Sirius Red staining. The results showed that the nilotinib-loaded microneedles patch could effectively attenuate fibrosis expansion in the peri-infarct zone and myocardial hypertrophy, prevent adverse ventricular remodeling and finally improve cardiac function. This treatment strategy is a beneficial attempt to correct the cardiac dysfunction after myocardial infarction, which is expected to become a new strategy to correct the cardiac dysfunction after MI. This is of great clinical significance for improving the long-term prognosis of MI patients.
ObjectiveTo investigate the preoperative cognition of the patients undergoing daytime ophthalmic fundus surgery and understand their needs of health education, so as to provide an evidence for efficient and accurate preoperative health education services within the limited time of the ophthalmic day fundus surgery.MethodsThe convenient sampling method was used to select the patients who met the inclusion criteria in the ambulatory operating room of Beijing Tongren Hospital, Capital Medical University from December 2017 to May 2018. The study included three parts: the general information of the patients, the preoperative cognition of the patients, and the needs for health education service of the patients. Questionnaires were designed according to the research purpose and method, which were distributed and recovered by professionals.ResultsA total of 112 patients were included. Among them, the cognitive scores of operation process (2.57±0.56), preoperative diet (2.58±0.59), preoperative medication (2.60±0.64), and psychological status (2.58±0.65) were relatively low. More health education services were needed in three aspects: the cognition of operation details [operation duration (85.71%), surgeons (79.46%), operation start time (76.79%)], intraoperative cooperation (90.18%), and intervention for preoperative anxiety (78.57%).ConclusionNurses should formulate the contents of preoperative health education according to the preoperative cognition and nursing needs of patients, so as to provide efficient and accurate health education services for patients.
ObjectivesTo systematically review the training needs of managing staffs in tertiary hospitals in China, to understand the requirements of in-service training for hospital managing staffs, and to provide references for the target and content of tertiary hospital managing staff training.MethodsPubMed, EMbase, CNKI, WanFang Data and VIP databases were searched to collect cross-sectional studies on the training needs of managing staffs in tertiary hospitals in China. The retrieval time was from inception to July 29th, 2018. Two reviewers independently screened literature, extracted the data and descriptive analysis was conducted on the training needs of managing staffs in tertiary hospitals.ResultsA total of 11 studies were included. The results of systematic review suggested that: as for the requirements of training content, hospital management, leadership, personnel training, human resource management and innovation awareness were the most demanding training contents. As for the training methods, experience exchange, case study and topic teaching were the most popular. As for the training time, 2 to 3 days of quarterly training was the most acceptable training time.ConclusionsThere are great training requirements for managing staffs in tertiary hospitals in China, with a large amount of training content and diversity methods. In future, training objectives and methods should be designed to meet the requirements of managing staffs, so as to enhance training quality and achieve training goals.
ObjectiveTo systematically review the diagnostic accuracy of C-arm cone-beam CT (CBCT)-guided percutaneous transthoracic needle biopsy (PTNB) for lung nodules. MethodsWe electronically searched databases including PubMed, EMbase, EBSCO, Ovid, CBM, VIP, WanFang Data and CNKI from inception to Feb 28th, 2015, to collect diagnostic studies of CBCT-guided PTNB for lung nodules. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies by QUADAS-1 tool. Then, meta-analysis was performed by Stata 12.0 and Meta-DiSc 1.4 softwares for calculating pooled sensitivity (Sen), specificity (Spe), positive likelihood ration (+LR), negative likelihood ration (-LR), and diagnostic odds ratio (DOR), drawing summary receiver operating characteristic (SROC) curve and estimating area under the curve (AUC). ResultsA total of 9 studies involving 1 815 patients were included. The results of meta-analysis showed that the pooled Sen, Spe, +LR,-LR, and DOR were 0.95 (95%CI 0.92 to 0.96), 1.00 (95%CI 0.66 to 1.00), 2 076.58 (95%CI 1.8 to 2.3e+0.6), 0.05 (95%CI 0.04 to 0.08), and 39 443.88 (95%CI 30.53 to 5.1e+0.7), respectively. The AUC of SROC was 0.97 (95%CI 0.95 to 0.98). ConclusionCBCT-guided PTNB can be used as one of the primary examination approaches for lung nodules with relatively high diagnostic accuracy. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo understand the follow-up needs of postoperative patients with thyroid cancer and analyze its influencing factors, so as to provide a reference for the establishment of a follow-up management system for patients with thyroid cancer.MethodsConvenience sampling was used to conduct a questionnaire survey on the follow-up need, recovery, anxiety, and stress of patients after thyroid cancer surgery in 2 tertiary A hospitals from March to April in 2020. The self-designed follow-up needs questionnaire, the Quality of Recovery Questionnaire 15 (QoR-15), the Generalized Anxiety Disorder-7 (GAD-7), and the Perceived Stress Scale (PSS-4) were scored. The higher score, the higher need, the better recovery, and the more serious anxiety and stress.ResultsIn this study, 382 questionnaires were distributed, which of 351 were returned and of 349 were valid, the valid callback rate was 99.4% (349/351). ① Follow-up needs. Follow-up form: Online platform was the preferred follow-up method (72.2%), the most patients hoped that the follow-up would be conducted by a doctor (82.5%) and hoped to start the follow-up at 1 month after the operation (67.6%) and in the afternoon (50.7%), the duration of each follow-up was 10–15 min (47.3%), and accepted the follow-up frequency of 1 times per month (41.3%) and the lifetime follow-up (69.9%). Needs degree of follow-up contents: There were 13 follow-up items requiring more than 80% of patients. The top 5 items with the higher follow-up needs score were the question on test results, returning visit guidance, knowledges of metastasis and recurrence, medication guidance, and issuance of inspection orders, and their scores were 4.78±0.47, 4.70±0.51, 4.70±0.57, 4.65±0.59, 4.57±0.64, respectively. The results of multiple linear regression analysis were found that the age (young), marital status (unmarried), medical payment method (with medical insurance), and postoperative interval (<1 month) were closely related to the follow-up needs score (P<0.05). ② Recovery, anxiety, and stress statuses: The total QoR-15 score of patients was 79.87±29.95, which was positively correlated with the total score of follow-up needs (72.93±8.52, r=0.131, P=0.014). No significant correlation was found between the total score of GAD-7 (4.77±3.59) or PSS-4 (6.51±3.10) and the total score of follow-up needs (r=0.068, P=0.207; r=0.008, P=0.881).ConclusionsYoung, unmarried, medically insured, and early postoperative patients with thyroid cancer have higher follow-up needs. Patients with better recovery after surgery have a higher follow-up needs. Medical staff should pay attention to follow-up services after discharge, rationally arrange content, frequency, and time period of follow-up according to follow-up needs of patients, so as to improve quality of medical services.
ObjectiveTo assess the care needs of outpatients in stomatological hospital and provide evidence for the improvement of patients' satisfaction. MethodsAccording to the characteristics of outpatients in stomatological hospital, a convenience sample of 150 cases was assessed with care needs survey based on Kano Model between May 2011 to February 2012. ResultsAmong all the care needs, 6 were essential, 11 were expected, and 3 had an attractive quality. Essential and attractive care needs accounted for 70% of all items. In the quadrant chart analysis, there were 8 items in competitive advantage district and 12 in the urgent improvement district respectively. ConclusionKano model is a quality attributive recognition tool. Through the analysis of the questionnaire, we believe the hospital should improve such aspects as information disclosure, public facilities, appointment, optimization process, and shortening patients' waiting time, in order to meet patients' needs by providing them with high quality services.
Objective To systematically evaluate the related factors that lead to the underestimation of puncture pathology of ductal carcinoma in situ (DCIS), and to reduce the underestimation rate of puncture pathology of DCIS by controlling related factors. Methods A computer search of PubMed, Web of Science, The Cochrane Library, EMbase, CNKI, and Wanfang databases were conducted to retrieve clinical studies that led to underestimation of puncture pathology for DCIS between the establishment of the database and April 1, 2021. After two researchers independently screened the literatures, extracted the data, and evaluated the risk of bias in the included studies, RevMan 5.4 software was used for meta analysis. Results A total of 24 studies including 8 810 patients were included. Results of meta analysis showed that puncture pathology underestimation rate in patients ≥50 years old was lower than that <50 years old [OR=0.82, 95%CI (0.70, 0.96), P=0.020]. Breast imaging reporting and data system (BI-RADS) of DCIS ≤4A class patients had a lower puncture pathology underestimation rate [OR=0.38, 95%CI (0.21, 0.68), P=0.001]. Human epidermal growth factorreceptor 2 (HER2) negative [OR=1.69, 95%CI (1.12, 2.55), P=0.010], no calcification in the mass [OR=1.55, 95%CI (1.10, 2.18), P=0.010], estrogen receptor (ER) positive [OR=0.73, 95%CI (0.60, 0.89), P=0.001], progesterone receptor (PR) positive [OR=0.62, 95%CI (0.44, 0.86), P=0.004], tumor diameter ≤2 cm [OR=2.98, 95%CI (2.18, 4.09), P<0.001], DCIS patients with low/intermediate nuclear grading [OR=0.58, 95%CI (0.50, 0.68), P<0.001], and untouchable masses [OR=0.48, 95%CI (0.28, 0.82), P=0.008] had lower puncture pathology underestimation rate. Conclusions In patients with DCIS, age≥50 years, BI-RADS≤4A class, mass diameter ≤2 cm, non-palpable mass, low nuclear grade (low grade/medium grade DCIS), ER positive, PR positive, HER2 negative, and no calcification can reduce the underestimation rate of puncture pathology. Due to the limitation of the number and quality of included studies, the above conclusions need to be confirmed by the results of high quality cohort studies with large samples.