Objective To provide the objective basis for the evaluation of the operative results of vascularized greater trochanter bone flap in treating osteonecrosis of the femoral head (ONFH) by three-dimensional gait analysis. Methods Between March 2006 and March 2007, 35 patients with ONFH were treated with vascularized greater trochanter bone flap, and gait analysis was made by using three-dimensional gait analysis system before operation and at 1, 2 years afteroperation. There were 23 males and 12 females, aged 21-52 years (mean, 35.2 years), including 8 cases of steroid-induced, 7 cases of traumatic, 6 cases of alcohol ic, and 14 cases of idiopathic ONFH. The left side was involved in 15 cases, and right side in 20 cases. According to Association Research Circulation Osseous (ARCO) classification, all patients were diagnosed as having femoral-head necrosis at stage III. Preoperative Harris hip functional score (HHS) was 56.2 ± 5.6. The disease duration was 1.5-18.6 years (mean, 5.2 years). Results All incisions healed at stage I without early postoperative compl ications of deep vein thrombosis and infections of incision. Thirty-five patients were followed up 2-3 years with an average of 2.5 years. At 2 years after operation, the HHS score was 85.8 ± 4.1, showing significant difference when compared with the preoperative score (t=23.200, P=0.000). Before operation, patients showed a hip muscles gait, short gait, reduce pain gait, and the pathological gaits significantly improved at 1 year after operation. At 1 year and 2 years after operation, step frequency, pace, step length and hip flexion, hip extension, knee flexion, ankle flexion were significantly improved (P lt; 0.01). Acceleration-time curves showed that negative wave and spinous wave at acceleration-stance phase of front feet and hind feet in affected l imb were obviously reduced at 1 year and 2 years after operation. Postoperative petronas wave appeared at swing phase; the preoperative situation was three normal phase waves. Conclusion These results suggest that three-dimensional gait analysis before and after vascularized greater trochanter for ONFH can evaluate precisely hip vitodynamics variation.
ObjectiveTo explore the clinical effectiveness of two kinds of treatment methods to nurse wound after tracheotomy. MethodsWe collected 108 cases and randomly divided them into two groups between March 2012 and May 2013. The experimental group (n=52) received tracheotomy care with PermaFoam dressing, while the control group (n=56) was treated with traditional sterile absorbent gauze. We analyzed the differences in terms of infection of wound, errhysis and frequency of dressing changes between the two groups. ResultsThe experimental group had a lower rate of wound infection than the control group (P<0.05). Moreover, the experimental group was superior to the control group in the total number of dressing changes, wound redness and oozing (P<0.05). ConclusionPermaFoam dressing can reduce wound complications and frequency of dressing changes effectively. It is easy to operate, and can reduce the workload of clinical nursing, and deserves clinical application.
ObjectiveTo review the present clinical evaluation of treatment for chronic low back pain. MethodsThe literature on the effectiveness evaluation method of chronic low back pain was reviewed and summarized. ResultsMany scoring systems are used to assess the treatment for chronic low back pain through the evaluation of pain and functional disability. The function evaluations are divided into general and disease-specific evaluations. Currently the most widely used evaluation systems are as follows: short-form 36 health survey scale (SF-36), Oswestry disability index (ODI), Roland-Morris disability questionnaire (RDQ), Japanese Orthopaedic Association (JOA) low back pain scoring system, Quebec back pain disability scale (QBPDS), and Macnab criteria. Visual analogue scale (VAS) and numerical rating scale (NRS) are usually used to evaluate the pain degree. ConclusionThere are many effectiveness evaluation methods of chronic low back pain, but there is still a lack of more comprehensive, concise, and practical evaluation method. Further studies are required to develop it.
ObjectiveTo systematically review the effects of the promotion of appropriate health technology in China and provide reference for improving the promotion of appropriate health technologies. MethodsDatabases including CBM, VIP, CNKI and WanFang Data were searched for studies about the appropriate health technology in China from inception to August 2014. Two reviewers independently screened literature, extracted data, and assessed the methodological quality of included studies by the evaluation criteria for descriptive studies of MAStARI, an assessment tool developed by JBI Evidence-Based Health Care Center. And then, qualitative descriptive analysis method was used to comprehensively analyze the data from four aspects: medical institutions, regulators, technology promotion medical staff and patients. ResultsA total of 23 cross-sectional studies and one before-after study were included. The results of qualitative analysis showed that: 1) the technology utilization rate of appropriate health technology extension institutions was more than 70%, the number of outpatients of township and village organizations increased significantly than that of the county level institutions; 2) director of technology extension and managers of hospital were in favor of the promotion of appropriate technology for its good effectiveness, safety, lower medical costs, and skill improvement of medical staff; 3) medical staff mastered the appropriate health technology, they were willing to promote appropriate technology and spoke highly of it for its safety, feasibility and economic effect, and improved their level of technology; 4) in patients' opinion, the appropriate technology reduced the disease course and cost, they spoke highly of it for its acceptance, efficacy and safety. ConclusionCurrent evidence shows that the promotion of appropriate health technology has achieved good effects. The satisfaction of medical institutions, managers, health service staff and patient is high, but these research results are of poor quality, mostly subjective evaluation, lack of scientific, rational, objective and consistent evaluation criteria, which cannot be used as evaluation evidence for the promotion of appropriate health technology.