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.
Objective To define the attributes and priorities of evidence-based nursing curriculum needs of nursing students, so as to provide operational reference for the design and development of evidence-based nursing course in the future. Methods Questionnaire was designed based on Kano model, and convenient sampling method was adopted to investigate the nursing students who had received training or had experience in evidence-based nursing from September to November 2020. According to the Kano model attribute classification method, the need attribute of evidence-based nursing curriculum was defined. Results A total of 303 nursing students were investigated. Kano model analysis showed that 11 of the needs for evidence-based nursing courses were one-dimensional quality, which belonged to the dimension of teaching resources and teaching content, and 5 were indifference quality, which belonged to the course assessment dimension. The importance-satisfaction matrix showed that the need of evidence-based nursing curriculum was concentrated in the advantage area and minor excepting improvement area. Conclusions In the future curriculum design, evidence-based nursing teachers need to continue to maintain the demand items in the advantage area and constantly improve and perfect them. They also need to pay more attention to the demand items in the minor excepting improvement area. Combined with the current problems in evidence-based nursing practice and the evidence-based needs of students, teachers need to further put forward suggestions on evidence-based nursing curriculum.
OBJECTIVE To investigate the mechanism of electrothrombosis by copper needle, in order to supply the referential data for clinical treatment of vessel deformity. METHODS The mechanism and condition of thrombus formation by copper needle were studied in vivo and in vitro using electrophysics, atom absorption spectrophtometry, histological, and histochemical methods. RESULTS Great deal of copper ion was dissociated, and agglutination of red blood cells(RBC) in blood could be observed in vitro after the current applied by copper needles. Formation of stable thrombus was related to voltage and time of application of electric current. CONCLUSION Dissociation of copper ion and agglutination of RBC are the basic principle of electrothrombosis with copper needle. A 4V direct current and 17.5 minutes are the safe and effective conditions for thrombus formation in the blood vessels.
To analyze the cl inical effect of retained copper needles well as neoplasm l igation, retained copper needles associated with Pingyangmycin injection and inserted copper needles followed by DC in treating hemangiomaso as to treat hemangioma with copper needles. Methods From January 1999 to January 2006, 55 cases of hemangioma in superficial body were treated with copper needles, including 28 males and 27 females and aging 3-50 years(median 19 years). There were 42 cases of cavernous hemangiomas, 4 cases of racemose hemangiomas and 9 cases of multipl icate hemangiomas. The size ranged from 6 cm × 4 cm to 40 cm × 25 cm. Retaining copper needles were used in 29 cases, retaining copper needles with l igating neoplasm in 21 cases, retaining copper needles associated with Pingyangmycin injection in 3 cases and inserting copper needles followed by DC in 2 cases. Results Fifty cases were treated with copper needles only once and 5 cases twice. All cases were followed up for three to eighteen months. According to Wang Yongjie’s criterion, 15 (27.3%) cases were cured, 38 (69.1%) improved, and 2（3.6%）failed to respond; the response rate was 96.4% (53). Conclusion Copper needle is efffective for treating hemangioma in superficial body. Retaining copper needles with l igation neoplasm or with Pingyangmycin injection can achieve better effect.
Abstract： Objective To introduce the new procedure of endobronchial ultrasoundguided transbronchial needle aspiration (EBUSTBNA) for staging lung cancer and diagnosing thoracic diseases, in order to determine its value in the evaluation of thoracic diseases. Methods We retrospectively reviewed the data of all patients examined with EBUSTBNA our institution between September 2009 and May 2010. Among the patients, there were 75 males and 31 females with an average age of 62.3 years old. Based on their primary indication, we divided all the 106 patients into three categories. (1) There were 76 patients with known or bly suspected lung cancer. Enlarged mediastinal lymph nodes on radiographic examination of the chest (≥1.0 cm) were detected in all the patients. (2) There were 22 patients with enlarged mediastinal lymph nodes or mediastinal masses of unknown origin. (3) There were 8 patients with pulmonary mass located close to the central airways. Results (1) 76 patients underwent EBUSTBNA for known or bly suspected lung cancer. Among them, 58 patients were confirmed to have mediastinal lymph nodes metastasis on EBUSTBNA. Sixteen in the 18 patients with negative EBUSTBNA underwent thoracoscopy or thoracotomy for pulmonary resection and mediastinal lymph node dissection. Postoperative pathology confirmed that 12 patients did not have metastatic nodes, 2 patients had metastatic nodes and 2 other patients had benign lesions within the lung. The diagnostic sensitivity, specificity and accuracy of EBUSTBNA for the mediastinal staging of lung cancer were 96.66%(58/60), 100.00%(12/12) and 97.22%(70/72), respectively. (2) 22 patients underwent EBUSTBNA for the evaluation of mediastinal adenopathy or mass in the absence of any identifiable pulmonary lesion. Among them, 7 had malignancy, 13 had benign diseases on EBUSTBNA and the sensitivity of EBUSTBNA in distinguishing malignant mediastinal diseases was 87.50% (7/8). (3) 8 patients with pulmonary mass located close to the central airways were accessed by EBUSTBNA. Definite diagnosis was achieved in 7 patients, and lung cancer was detected in 6 patients. The sensitivity and the diagnostic accuracy of EBUSTBNA for the diagnosis of unknown pulmonary mass was 85.71%(6/7) and 87.50%(7/8), respectively. All the procedures were uneventful, and there were no complications. Conclusion EBUSTBNA is a highly effective and safe procedure. We believe that EBUSTBNA should be used routinely in the diagnosis and staging of thoracic diseases.
ObjectiveTo reduce patients' adverse events caused by needle indwelling through quality control circle (QCC) activities, in order to ensure the effectiveness and safety of intravenous fluids. MethodsGuided by the QCC theory, we set up QCC, selected the topic related to reduction of patients' adverse events caused by needle indwelling, and worked out the plans from September 2012 to April 2013. Then, we adopted Plan-Do-Check-Act (PDCA) cycle method to set up goals, formulate measures, and inspect and improve the results. ResultsThe incidence of needle-related adverse events reduced from 44.8% to 9.8% by implementation of quality circle activities. There was a significant statistical difference between the two groups (χ2=148.16, P<0.05). ConclusionQCC activity can not only reduce the adverse events incidence of needle indwelling, but also improve the nurses' working enthusiasm and responsibility, problem-solving skills and accomplishment, and promote team cohesion.
Drug administration via hollow microneedles (HMN) have the advantages of painlessness, avoidance of first-pass effect, capability of sustained infusion, and no need for professional personnel operation. In addition, HMN can also be applied in the fields of body fluid extraction and biosensors, showing broad application prospects. However, traditional manufacturing technologies cannot meet the demand for low-cost mass production of HMN, limiting its widespread application. This paper reviews the main manufacturing technologies used for HMN in recent years, which include photolithography and etching, laser etching, sputtering and electroplating, micro-molding, three-dimensional (3D) printing and drawing lithography. It further analyzes the characteristics and limitations of existing manufacturing technologies and points out that the combination of various manufacturing technologies can improve production efficiency to a certain extent. In addition, this paper looks forward to the future trends of HMN manufacturing technology and proposes possible directions for its development. In conclusion, it is expected that this review can provide new ideas and references for follow-up research.
ObjectiveTo evaluate the diagnostic value of BRAFV600E mutation test in high-risk thyroid nodules with easily underdiagnosed fine-needle aspiration biopsy (FNAB) results.MethodsRetrospectively collected 122 cases of thyroid nodule who treated in the Hebei Petrochina Central Hospital between January 2017 and December 2018, all the cases admitted preoperative ultrasound and FNAB detection. All of the patients had the non-positive cytological results of FNAB and the high-risk features of ultrasound. Contrasted the postoperative pathological coincidence rate of combination of FNAB and BRAFV600E test with FNAB alone.ResultsThe BRAFV600E mutation rate was 27.0% (33/122). The positive rate of BRAFV600E mutation increased with the increase of ultrasound thyroid imaging reporting and data system(TI-RADS) grade (P<0.05), which was independent of patients’ age, gender, number of nodules, diameter of nodules, and FNAB results (P>0.05). The coincidence rate of FNAB combined with BRAFV600E mutation detection was higher than that of FNAB alone ［86.9% (106/122) vs. 69.7% (85/122), P<0.05).ConclusionsThe BRAFV600E mutation test can detect papillary thyroid carcinoma that might be missed by FNAB. We recommend that FNAB should be routinely accompanied by the BRAFV600E mutation test in the high-risk thyroid nodules.
ObjectiveTo compare the diagnostic accuracy, sampling satisfaction, and safety of ultrasound-guided core needle biopsy (CNB) and fine needle aspiration biopsy (FNA) for thyroid nodules.MethodsThe databases of PubMed, Medline, Web of Science, Cochrane Library, Wanfang, CNKI, and CBM were searched to collect the relevant studies on the diagnostic performance, sampling satisfaction, and safety of ultrasound-guided CNB and FNA for thyroid nodules. Revman 5.3 and Stata 15 software were used for meta-analysis.ResultsA total of 24 studies involving 25 388 patients were included. Meta analysis showed that: compared with CNB, FNA had poor diagnostic accuracy ［OR=0.26, 95%CI (0.15, 0.46), P<0.000 01］, poor sampling satisfaction ［OR=0.20, 95%CI (0.12, 0.33), P<0.000 01］, lower incidence of total complications ［OR=0.28, 95%CI (0.16, 0.50), P<0.000 1］, and lower incidence of bleeding after biopsy ［OR=0.62, 95%CI (0.48, 0.81), P=0.000 3］. However, there was no significant difference in the pain score ［WMD=–0.21, 95%CI (–0.57, 0.15), P=0.26］ between the two groups. Subgroup analysis showed that there was no significant difference in the accuracy of biopsy diagnosis of thyroid nodules with diameter less than 10 mm between the two groups ［OR=0.52, 95%CI (0.15, 1.81), P=0.30］, however, the accuracy of CNB in the diagnosis of thyroid nodules with diameter ≥ 10 mm was still better than FNA ［OR=0.26, 95%CI (0.12, 0.56), P=0.000 5］.ConclusionsCompared with FNA, ultrasound-guided CNB has a certain advantages in sampling satisfaction and the diagnosis accuracy of thyroid nodules with diameter ≥ 10 mm. CNB is better than FNA, but will bring higher risk of complication.
Objective To summarize the basic principle of electrical impedance spectrum technology and the latest progress in the diagnosis of thyroid carcinoma. Methods By the domestic and overseas literatures review， medical application and diagnostic prospect in thyroid carcinoma of electrical impedance spectrum were summarized. Results Electrical impedance spectrum was a kind of somatic function imaging， whose measurement results was objective， and it could diagnose thyroid carcinoma in early stage effectively. In addition， it could be used as a complementary form of fine needle aspiration biopsy， improving the diagnostic accuracy rate of thyroid carcinoma， thereby reducing the unessential thyroid operations. Conclusion Electrical impedance spectrum technology is a potentially useful imaging modality for diagnosing thyroid carcinoma in early stage， and functions as a auxiliary clinical diagnosis method for fine needle aspiration biopsy.