Children's fractures are very common,and many children's fractures need internal fixation.When the children are treated and recovered,it needs to be internally fixed and then taken out.With the development of ...Children's fractures are very common,and many children's fractures need internal fixation.When the children are treated and recovered,it needs to be internally fixed and then taken out.With the development of internal fixation materials,the research of surgical methods and the improvement of surgical skills,postoperative removal of orthopedic surgery patients has gradually been included in daytime surgery.While ensuring the safety of children's surgery,it is necessary to shorten the postoperative limb and joint function recovery time,promote the recovery of limb and joint function,the healing of wounds and bones,and reduce the occurrence of these complications.In order to reduce the occurrence of these complications,carry out early rehabilitation education and development early rehabilitation training is very necessary.This paper puts forward the concept of early rehabilitation based on shared decision model,in which doctors,nurses,children and family members participate in the treatment of children before,during and after operation.The effect of early rehabilitation education in the daytime ward after removal of internal fixation was examined.Moreover,through the analysis of the control trial also confirmed that the clinical effect of early rehabilitation in improving and optimizing the rehabilitation of fracture in children is significant.展开更多
BACKGROUND Current research has identified several risk factors for refractory benign esophageal strictures (RBES), but research is scarce on the prediction of RBES in benign esophageal strictures patients. Meanwhile,...BACKGROUND Current research has identified several risk factors for refractory benign esophageal strictures (RBES), but research is scarce on the prediction of RBES in benign esophageal strictures patients. Meanwhile, the long-term outcomes of RBES remain unclear. The aim of this study was to develop and validate a model to determine the progression of RBES in patients with benign esophageal strictures. And we also explored the long-term outcomes and safety in patients with RBES. AIM To develop and validate a model to determine the progression of RBES in patients with benign esophageal strictures, based on the demographic data and endoscopic findings. METHODS A total of 507 benign esophageal stricture patients treated by dilation alone or in combination with stenting were retrospectively enrolled between January 2009 and February 2018. The primary outcome was to establish a risk-scoring model predicting RBES in benign esophageal strictures. The secondary outcome was to explore the clinical effectiveness and adverse events in patients with RBES. RESULTS In the study, age, etiology, and number and length of strictures were the independent risk factors for the refractory performance of benign esophageal strictures. According to risk factors of benign esophageal strictures, a risk-scoring model for predicting RBES in benign esophageal strictures was established: The risk score ranged from 0 to 8 points, and the risk scores were divided into low risk (0-2 points), intermediate risk (3-5 points), and high risk (6-8 points). The proportions of RBES in the corresponding risk categories were 1.0%, 12.2%, and 76.0%, respectively. Among 507 patients, 57 had RBES (39 males;median age, 60 years). The success rate of dilation treatment (51.2%, 21/41) was higher than that of stent placement (37.5%, 6/16). CONCLUSION In this study, 11.3%(57/507) patients had RBES at our hospital. The risk-scoring model predicting RBES in benign esophageal strictures could predict the longterm outcome of patients with strictures ahead.展开更多
Introduction Gallstone disease is a major public-health problem,with a high prevalence ranging from 10%to 15%[1].Acute cholecystitis,chronic cholecystitis,choledocholithiasis,and gallstone pancreatitis are all common ...Introduction Gallstone disease is a major public-health problem,with a high prevalence ranging from 10%to 15%[1].Acute cholecystitis,chronic cholecystitis,choledocholithiasis,and gallstone pancreatitis are all common complications in clinical practice.However,when gallstones migrate to adjacent viscera or vascular structures,the clinical challenge is far less familiar[2].Gallbladder(GB)bleeding is seldom reported,which mostly manifests as hemobilia.Some cases are caused by cystic artery aneurysm and rupture and others are due to GB rupture[3].Gallstones can erode through the gallbladder wall or bile duct into the adjacent portion,resulting in a cholecystocolonic fistula(CCF),which is a rare complication of gallstones with cholecystitis[4].Here,we share a case of gallbladder bleeding along with cholecystocolonic fistula that has not yet been reported.We hope that,through our unusual case,clinicians gain an enhanced understanding of rare complications caused by gallstones.展开更多
基金supported by Nanjing Medical Science and Technology Development Project(No.YKK13138).
文摘Children's fractures are very common,and many children's fractures need internal fixation.When the children are treated and recovered,it needs to be internally fixed and then taken out.With the development of internal fixation materials,the research of surgical methods and the improvement of surgical skills,postoperative removal of orthopedic surgery patients has gradually been included in daytime surgery.While ensuring the safety of children's surgery,it is necessary to shorten the postoperative limb and joint function recovery time,promote the recovery of limb and joint function,the healing of wounds and bones,and reduce the occurrence of these complications.In order to reduce the occurrence of these complications,carry out early rehabilitation education and development early rehabilitation training is very necessary.This paper puts forward the concept of early rehabilitation based on shared decision model,in which doctors,nurses,children and family members participate in the treatment of children before,during and after operation.The effect of early rehabilitation education in the daytime ward after removal of internal fixation was examined.Moreover,through the analysis of the control trial also confirmed that the clinical effect of early rehabilitation in improving and optimizing the rehabilitation of fracture in children is significant.
文摘BACKGROUND Current research has identified several risk factors for refractory benign esophageal strictures (RBES), but research is scarce on the prediction of RBES in benign esophageal strictures patients. Meanwhile, the long-term outcomes of RBES remain unclear. The aim of this study was to develop and validate a model to determine the progression of RBES in patients with benign esophageal strictures. And we also explored the long-term outcomes and safety in patients with RBES. AIM To develop and validate a model to determine the progression of RBES in patients with benign esophageal strictures, based on the demographic data and endoscopic findings. METHODS A total of 507 benign esophageal stricture patients treated by dilation alone or in combination with stenting were retrospectively enrolled between January 2009 and February 2018. The primary outcome was to establish a risk-scoring model predicting RBES in benign esophageal strictures. The secondary outcome was to explore the clinical effectiveness and adverse events in patients with RBES. RESULTS In the study, age, etiology, and number and length of strictures were the independent risk factors for the refractory performance of benign esophageal strictures. According to risk factors of benign esophageal strictures, a risk-scoring model for predicting RBES in benign esophageal strictures was established: The risk score ranged from 0 to 8 points, and the risk scores were divided into low risk (0-2 points), intermediate risk (3-5 points), and high risk (6-8 points). The proportions of RBES in the corresponding risk categories were 1.0%, 12.2%, and 76.0%, respectively. Among 507 patients, 57 had RBES (39 males;median age, 60 years). The success rate of dilation treatment (51.2%, 21/41) was higher than that of stent placement (37.5%, 6/16). CONCLUSION In this study, 11.3%(57/507) patients had RBES at our hospital. The risk-scoring model predicting RBES in benign esophageal strictures could predict the longterm outcome of patients with strictures ahead.
文摘Introduction Gallstone disease is a major public-health problem,with a high prevalence ranging from 10%to 15%[1].Acute cholecystitis,chronic cholecystitis,choledocholithiasis,and gallstone pancreatitis are all common complications in clinical practice.However,when gallstones migrate to adjacent viscera or vascular structures,the clinical challenge is far less familiar[2].Gallbladder(GB)bleeding is seldom reported,which mostly manifests as hemobilia.Some cases are caused by cystic artery aneurysm and rupture and others are due to GB rupture[3].Gallstones can erode through the gallbladder wall or bile duct into the adjacent portion,resulting in a cholecystocolonic fistula(CCF),which is a rare complication of gallstones with cholecystitis[4].Here,we share a case of gallbladder bleeding along with cholecystocolonic fistula that has not yet been reported.We hope that,through our unusual case,clinicians gain an enhanced understanding of rare complications caused by gallstones.