Forearm fractures are prevalent which include radius fractures,ulna fractures,or both radius and ulna fractures.Proximal radius fractures combined with dislocations of the radial heads are rare and easily misdiagnosed...Forearm fractures are prevalent which include radius fractures,ulna fractures,or both radius and ulna fractures.Proximal radius fractures combined with dislocations of the radial heads are rare and easily misdiagnosed.The authors present and discuss a case of proximal radius fractures associated with radial head dislocations.A 36 years old male was admitted to the hospital due to pain and activity limitation in his left elbow for 7 hours due to a car accident.An X-ray of the left elbow joint revealed a“left radius fracture with surrounding soft tissue edema”.During the procedure,the radial head was found to be dislocated forward.A 3.0 mm anchor was used to fix the annular ligament.Radius fractures combined dislocations of the radial heads are rare and may be missing the diagnosis.Before undergoing surgery,the possibility of elbow dislocation should be evaluated.Wire anchors can provide reliable fixation.展开更多
Introduction: In India, 57% of patients with head and neck cancers are documented with nutritional compromise. Active nutritional support has been shown to improve outcomes and reduce the cost of treatment in severely...Introduction: In India, 57% of patients with head and neck cancers are documented with nutritional compromise. Active nutritional support has been shown to improve outcomes and reduce the cost of treatment in severely malnourished patients. The assessment of nutritional status should be a priority when initiating medical nutrition therapy. We evaluated the agreement between Subjective and Objective evaluation of pre-operative nutrition status of head and neck cancer patients in a tertiary cancer centre. Methods: Two hundred and thirty seven head and neck cancer patients who underwent surgery were eligible. The patients included both males (147) and females (90) with age varying between 23 - 88 years. All patients were screened for pre-operative nutrition status objectively as well as subjectively. The association of pre-operative SGA scores (A, B and C) subjectively, and PNS score (0, 1, 2) objectively were tested for statistical significance. Results: The cancer sites included tongue in 82, buccal mucosa in 30, thyroid in 28, alveolus in 18, glottis in 10, RMT in 10, nasal cavity in 9, FOM in 8. The pre-operative nutrition status based on subjective scores are A in 156 (65.8%), B in 75 (32%) and C in 6 (2.5%). The objective parameters obtained on the basis of BMI, % weight loss, PNI and S. albumin values are PNS 0 in 161 (67.9%), PNS 1 in 71 (30%) and PNS 2 in 5 (2.1%) patients. As the kappa coefficient p-0.56, there is moderate agreement between the pre-operative nutrition status subjectively as well as objectively. Conclusion: Subjective global assessment is a simple and inexpensive way to screen the pre-operative nutrition status when compared to the other objective assessment tool. SGA has moderate agreement with expensive and complicated objective assessment tools. So it can be a reliable tool for assessing the pre-operative nutrition status.展开更多
BACKGROUND Traumatic radial head dislocation(RHD)is a well-described injury in the pediatric population.It is usually associated with an injury to the ulna in Monteggia fracture-dislocation,although it can occur as an...BACKGROUND Traumatic radial head dislocation(RHD)is a well-described injury in the pediatric population.It is usually associated with an injury to the ulna in Monteggia fracture-dislocation,although it can occur as an isolated injury.Traumatic RHD with ipsilateral radial shaft fracture has rarely been reported.Delayed RHD secondary to the malunion of an isolated radial shaft fracture is extremely rare.CASE SUMMARY We report a 9-year-old boy with limited pronation of the right elbow.The patient was diagnosed with delayed RHD associated with the malunion of a distal radial fracture.Since the annular ligament was disrupted with forearm rotation causing subluxation of the radial head,a modified double-strip Bell Tawse procedure was performed to reconstruct the annular ligament without corrective osteotomy for the malunited site.Four years after surgery,the angulation deformity of the distal radius was corrected with the restoration of the normal curvature of the radius.There was no recurrence of RHD.CONCLUSION Annular ligament reconstruction without corrective osteotomy could reduce RHD and restore the normal curve of the radial shaft in children with delayed dislocation of the radial head associated with malunion of the radial shaft.Annular reconstruction using double triceps tendon strips might be useful for maintaining a more stable reduction by augmenting anterolateral parts.展开更多
Radial head and neck fractures represent up to 14%of all pediatric elbow fractures and can be a difficult challenge in the pediatric patient.In up to 39%of proximal radius fractures,there is a concomitant fracture,whi...Radial head and neck fractures represent up to 14%of all pediatric elbow fractures and can be a difficult challenge in the pediatric patient.In up to 39%of proximal radius fractures,there is a concomitant fracture,which can easily be overlooked on the initial standard radiographs.The treatment options for proximal radius fractures in children range from non-surgical treatment,such as immobilization alone and closed reduction followed by immobilization,to more invasive options,including closed reduction with percutaneous pinning and open reduction with internal fixation.The choice of treatment depends on the degree of angulation and displacement of the fracture and the age of the patient;an angulation of less than 30 degrees and translation of less than 50%is generally accepted,whereas a higher degree of displacement is considered an indication for surgical intervention.Fractures with limited displacement and non-surgical treatment generally result in superior outcomes in terms of patient-reported outcome measures,range of motion and complications compared to severely displaced fractures requiring surgical intervention.With proper management,good to excellent results are achieved in most cases,and long-term sequelae are rare.However,severe complications do occur,including radio-ulnar synostosis,osteonecrosis,rotational impairment,and premature physeal closure with a malformation of the radial head as a result,especially after more invasive procedures.Adequate follow-up is therefore warranted.展开更多
自然语言生成(Natural Language Generation,NLG)任务是自然语言处理(Natural Languge Processing,NLP)任务中的一个子类,并且是一项具有挑战性的任务。随着深度学习在自然语言处理中的大量应用,其已经变成自然语言生成中处理各种任务...自然语言生成(Natural Language Generation,NLG)任务是自然语言处理(Natural Languge Processing,NLP)任务中的一个子类,并且是一项具有挑战性的任务。随着深度学习在自然语言处理中的大量应用,其已经变成自然语言生成中处理各种任务的主要方法。自然语言生成任务中主要有问答任务、生成摘要任务、生成评论任务、机器翻译任务、生成式对话任务等。传统的生成模型依赖输入文本,基于有限的知识生成文本。为解决这个问题,引入了知识增强的方法。首先介绍了自然语言生成的研究背景和重要模型,然后针对自然语言处理归纳介绍了提高模型性能的方法,以及基于内部知识(如提取关键词增强生成、围绕主题词等)和外部知识(如借助外部知识图谱增强生成)集成到文本生成过程中的方法和架构。最后,通过分析生成任务面临的一些问题,讨论了未来的挑战和研究方向。展开更多
When conducting a literature review,medical authors typically search for relevant keywords in bibliographic databases or on search engines like Google.After selecting the most pertinent article based on the title’s r...When conducting a literature review,medical authors typically search for relevant keywords in bibliographic databases or on search engines like Google.After selecting the most pertinent article based on the title’s relevance and the abstract’s content,they download or purchase the article and cite it in their manuscript.Three major elements influence whether an article will be cited in future manuscripts:the keywords,the title,and the abstract.This indicates that these elements are the“key dissemination tools”for research papers.If these three elements are not determined judiciously by authors,it may adversely affect the manuscript’s retrievability,readability,and citation index,which can negatively impact both the author and the journal.In this article,we share our informed perspective on writing strategies to enhance the searchability and citation of medical articles.These strategies are adopted from the principles of search engine optimization,but they do not aim to cheat or manipulate the search engine.Instead,they adopt a reader-centric content writing methodology that targets well-researched keywords to the readers who are searching for them.Reputable journals,such as Nature and the British Medical Journal,emphasize“online searchability”in their author guidelines.We hope that this article will encourage medical authors to approach manuscript drafting from the perspective of“looking inside-out.”In other words,they should not only draft manuscripts around what they want to convey to fellow researchers but also integrate what the readers want to discover.It is a call-to-action to better understand and engage search engine algorithms,so they yield information in a desired and self-learning manner because the“Cloud”is the new stakeholder.展开更多
Dislocation of the radial head in adults is uncommon. A simultaneous dislocation of the radial head and fracture of the ipsilateral distal end of radius with no other associated injuries is extremely rare. As far as w...Dislocation of the radial head in adults is uncommon. A simultaneous dislocation of the radial head and fracture of the ipsilateral distal end of radius with no other associated injuries is extremely rare. As far as we know, such an injury after an unusual mode of injury has been seldom reported in the English literature. We report such a case without any associated injuries or comorbidity. Closed reduction was performed within two hours after injury and results were satisfactory. Immobilisation was continued for3 weeks. Gradual mobilisation was started after removal of the plaster under the supervision of a physiotherapist. At 6 months＇ follow-up, the patient had no residual pain at the elbow with full flexion ＆ extension. Almost full supination with a restriction of last 10 degrees of pronation was achieved. There was no evidence of instability of the elbow.展开更多
A new injury pattern of comminuted fractures of ipsilateral radial head and distal radius of forearm in an adult was described. To the best of our knowledge, this type of injury pattern had not been previously reporte...A new injury pattern of comminuted fractures of ipsilateral radial head and distal radius of forearm in an adult was described. To the best of our knowledge, this type of injury pattern had not been previously reported in the English literature. The possible mechanisms of injury were that the rebound forces were volar to the distal radius as the fracture was dorsally angulated, with a continuation of the radial head fracture due to the longitudinal impaction of the radius against the capitellum. Open reduction and internal fixation can obtain excellent results within 7 12 days after injury. We hope that our experience will increase the awareness of the occurrence of a double injury of the forearm.展开更多
基金The authors acknowledge the financially support received from the Medicine and Health Project of Zhejiang Province(2022KY1288,2022KY1313)General Research Project of Zhejiang Provincial Department of Education(LY202043116,Y202145976)Science and Technology Project of Shaoxing City(2020A13011).
文摘Forearm fractures are prevalent which include radius fractures,ulna fractures,or both radius and ulna fractures.Proximal radius fractures combined with dislocations of the radial heads are rare and easily misdiagnosed.The authors present and discuss a case of proximal radius fractures associated with radial head dislocations.A 36 years old male was admitted to the hospital due to pain and activity limitation in his left elbow for 7 hours due to a car accident.An X-ray of the left elbow joint revealed a“left radius fracture with surrounding soft tissue edema”.During the procedure,the radial head was found to be dislocated forward.A 3.0 mm anchor was used to fix the annular ligament.Radius fractures combined dislocations of the radial heads are rare and may be missing the diagnosis.Before undergoing surgery,the possibility of elbow dislocation should be evaluated.Wire anchors can provide reliable fixation.
文摘Introduction: In India, 57% of patients with head and neck cancers are documented with nutritional compromise. Active nutritional support has been shown to improve outcomes and reduce the cost of treatment in severely malnourished patients. The assessment of nutritional status should be a priority when initiating medical nutrition therapy. We evaluated the agreement between Subjective and Objective evaluation of pre-operative nutrition status of head and neck cancer patients in a tertiary cancer centre. Methods: Two hundred and thirty seven head and neck cancer patients who underwent surgery were eligible. The patients included both males (147) and females (90) with age varying between 23 - 88 years. All patients were screened for pre-operative nutrition status objectively as well as subjectively. The association of pre-operative SGA scores (A, B and C) subjectively, and PNS score (0, 1, 2) objectively were tested for statistical significance. Results: The cancer sites included tongue in 82, buccal mucosa in 30, thyroid in 28, alveolus in 18, glottis in 10, RMT in 10, nasal cavity in 9, FOM in 8. The pre-operative nutrition status based on subjective scores are A in 156 (65.8%), B in 75 (32%) and C in 6 (2.5%). The objective parameters obtained on the basis of BMI, % weight loss, PNI and S. albumin values are PNS 0 in 161 (67.9%), PNS 1 in 71 (30%) and PNS 2 in 5 (2.1%) patients. As the kappa coefficient p-0.56, there is moderate agreement between the pre-operative nutrition status subjectively as well as objectively. Conclusion: Subjective global assessment is a simple and inexpensive way to screen the pre-operative nutrition status when compared to the other objective assessment tool. SGA has moderate agreement with expensive and complicated objective assessment tools. So it can be a reliable tool for assessing the pre-operative nutrition status.
文摘BACKGROUND Traumatic radial head dislocation(RHD)is a well-described injury in the pediatric population.It is usually associated with an injury to the ulna in Monteggia fracture-dislocation,although it can occur as an isolated injury.Traumatic RHD with ipsilateral radial shaft fracture has rarely been reported.Delayed RHD secondary to the malunion of an isolated radial shaft fracture is extremely rare.CASE SUMMARY We report a 9-year-old boy with limited pronation of the right elbow.The patient was diagnosed with delayed RHD associated with the malunion of a distal radial fracture.Since the annular ligament was disrupted with forearm rotation causing subluxation of the radial head,a modified double-strip Bell Tawse procedure was performed to reconstruct the annular ligament without corrective osteotomy for the malunited site.Four years after surgery,the angulation deformity of the distal radius was corrected with the restoration of the normal curvature of the radius.There was no recurrence of RHD.CONCLUSION Annular ligament reconstruction without corrective osteotomy could reduce RHD and restore the normal curve of the radial shaft in children with delayed dislocation of the radial head associated with malunion of the radial shaft.Annular reconstruction using double triceps tendon strips might be useful for maintaining a more stable reduction by augmenting anterolateral parts.
文摘Radial head and neck fractures represent up to 14%of all pediatric elbow fractures and can be a difficult challenge in the pediatric patient.In up to 39%of proximal radius fractures,there is a concomitant fracture,which can easily be overlooked on the initial standard radiographs.The treatment options for proximal radius fractures in children range from non-surgical treatment,such as immobilization alone and closed reduction followed by immobilization,to more invasive options,including closed reduction with percutaneous pinning and open reduction with internal fixation.The choice of treatment depends on the degree of angulation and displacement of the fracture and the age of the patient;an angulation of less than 30 degrees and translation of less than 50%is generally accepted,whereas a higher degree of displacement is considered an indication for surgical intervention.Fractures with limited displacement and non-surgical treatment generally result in superior outcomes in terms of patient-reported outcome measures,range of motion and complications compared to severely displaced fractures requiring surgical intervention.With proper management,good to excellent results are achieved in most cases,and long-term sequelae are rare.However,severe complications do occur,including radio-ulnar synostosis,osteonecrosis,rotational impairment,and premature physeal closure with a malformation of the radial head as a result,especially after more invasive procedures.Adequate follow-up is therefore warranted.
文摘自然语言生成(Natural Language Generation,NLG)任务是自然语言处理(Natural Languge Processing,NLP)任务中的一个子类,并且是一项具有挑战性的任务。随着深度学习在自然语言处理中的大量应用,其已经变成自然语言生成中处理各种任务的主要方法。自然语言生成任务中主要有问答任务、生成摘要任务、生成评论任务、机器翻译任务、生成式对话任务等。传统的生成模型依赖输入文本,基于有限的知识生成文本。为解决这个问题,引入了知识增强的方法。首先介绍了自然语言生成的研究背景和重要模型,然后针对自然语言处理归纳介绍了提高模型性能的方法,以及基于内部知识(如提取关键词增强生成、围绕主题词等)和外部知识(如借助外部知识图谱增强生成)集成到文本生成过程中的方法和架构。最后,通过分析生成任务面临的一些问题,讨论了未来的挑战和研究方向。
文摘When conducting a literature review,medical authors typically search for relevant keywords in bibliographic databases or on search engines like Google.After selecting the most pertinent article based on the title’s relevance and the abstract’s content,they download or purchase the article and cite it in their manuscript.Three major elements influence whether an article will be cited in future manuscripts:the keywords,the title,and the abstract.This indicates that these elements are the“key dissemination tools”for research papers.If these three elements are not determined judiciously by authors,it may adversely affect the manuscript’s retrievability,readability,and citation index,which can negatively impact both the author and the journal.In this article,we share our informed perspective on writing strategies to enhance the searchability and citation of medical articles.These strategies are adopted from the principles of search engine optimization,but they do not aim to cheat or manipulate the search engine.Instead,they adopt a reader-centric content writing methodology that targets well-researched keywords to the readers who are searching for them.Reputable journals,such as Nature and the British Medical Journal,emphasize“online searchability”in their author guidelines.We hope that this article will encourage medical authors to approach manuscript drafting from the perspective of“looking inside-out.”In other words,they should not only draft manuscripts around what they want to convey to fellow researchers but also integrate what the readers want to discover.It is a call-to-action to better understand and engage search engine algorithms,so they yield information in a desired and self-learning manner because the“Cloud”is the new stakeholder.
文摘Dislocation of the radial head in adults is uncommon. A simultaneous dislocation of the radial head and fracture of the ipsilateral distal end of radius with no other associated injuries is extremely rare. As far as we know, such an injury after an unusual mode of injury has been seldom reported in the English literature. We report such a case without any associated injuries or comorbidity. Closed reduction was performed within two hours after injury and results were satisfactory. Immobilisation was continued for3 weeks. Gradual mobilisation was started after removal of the plaster under the supervision of a physiotherapist. At 6 months＇ follow-up, the patient had no residual pain at the elbow with full flexion ＆ extension. Almost full supination with a restriction of last 10 degrees of pronation was achieved. There was no evidence of instability of the elbow.
文摘A new injury pattern of comminuted fractures of ipsilateral radial head and distal radius of forearm in an adult was described. To the best of our knowledge, this type of injury pattern had not been previously reported in the English literature. The possible mechanisms of injury were that the rebound forces were volar to the distal radius as the fracture was dorsally angulated, with a continuation of the radial head fracture due to the longitudinal impaction of the radius against the capitellum. Open reduction and internal fixation can obtain excellent results within 7 12 days after injury. We hope that our experience will increase the awareness of the occurrence of a double injury of the forearm.
