ObjectiveTo learn about the awareness of medical liability-related provisions of Tort Liability Act of undergraduates in medical schools, thus to provide reference for the modification of teaching plans of undergraduate medical education. MethodsBetween September and December 2012, we conducted a sampling survey on undergraduates of West China Medical School using a self-designed questionnaire about medical liability-related provisions of Tort Liability Act. ResultsGenerally, students'awareness of the provisions was low, and most of the students did not have a good understanding of the provisions related to medical disputes. The respondents'knowledge of medical liability-related provisions of Tort Liability Act did not match with their grade in school and their level of medical knowledge. Most of their knowledge about medical law was learned from mass media. Undergraduate medical students had an expectation to learn more about medical law from class. ConclusionMedical law classes should be put into the teaching plans of medical education.
ObjectiveTo investigate the impact of the Salter innominate osteotomy on the acetabular morphology and direction and the relationship between them in children with developmental dislocation of the hip (DDH) by three-dimensional CT. MethodsBetween January 2013 and January 2015, 51 patients with unilateral DDH were treated. All patients were females with an average age of 2 years and 5 months (range, one year and 6 months to 5 years). All the patients underwent open reduction of the hip, Salter innominate osteotomy, proximal femoral osteotomy, and hip cast immobilization for treatment. The data of three-dimensional CT before surgery and at 1 week after surgery were measured and collected as follows:the anterior acetabular index (AAI), posterior acetabular index (PAI), axial acetabular index (AxAI), acetabular anteversion angle (AAA) of the acetabulum, and the distances of the forward, outward, and lateral rotation of the distal osteotomy fragments. The differences of AAI, PAI, AxAI, AAA between before and after surgeries were compared and the difference values of the data with significant difference results were calculated. The relationship between the difference values and the distances of three different rotation directions before and after surgeries were tested by Spearman correlation analysis. ResultsThere were significant differences in the AAI, PAI, and AAA between before and after surgery (P<0.05), but no significant difference was found in the AxAI between before and after surgery (t=0.878, P=0.384). The difference values of AAI, PAI, and AAA were (4.518±4.601), (4.219±6.660), and (3.919±4.389)° respectively. The distances of the outward, lateral, and forward rotation of the distal osteotomy fragments after surgery were (0.420±0.339), (2.440±0.230), and (0.421±0.311) cm. There was a significant correlation between the three different rotation directions and AAI difference (P<0.05), especialy the outward rotation (r=0.981). There was a correlation between the outward, forward rotation and PAI, AAI differences (P<0.05), and no significant correlation between the lateral rotation and PAI, AAA was found (P>0.05). There was a significant correlation between the forward rotation and AAA difference (r=0.841). ConclusionSalter innominate osteotomy can increase the curvature of the anterior wall of the acetabulum in DDH, but reduce the curvature of the rear wall. At the same time, it can also change the direction of the acetabulum, significantly decrease the acetabular anteversion, but it can not change the depth of the acetabulum. The main factors of the curvature change after Salter innominate osteotomy of DDH is attributable to outward rotation, followed by forward rotation, and the main factor of the acetabular direction change is attributable to forward rotation.
Objective To comprehend the concept， pathology， molecular mechanisms， diagnosis， and treatmentof aggressive fibromatosis （AF）， and to find a novel way to cure aggressive fibromatosis. Method The literatures about the definition， molecular mechanisms， and clinical research of AF were reviewed and analized. Results AF is rare and benign fibromatous lesion that is the result of abnormal proliferation of myofibroblasts. The pathologic features of AF isa benign disease， but it has “malignant” biological behavior. The tumor often involved the surrounding organs and bloodvessels， and caused death of patients. For patients with clinical symptoms or complications， complete excision of thetumor is the treatment of choice. Even if the operation to ensure the negative margin also has a higher recurrence rate， soits treatment requires multidisciplinary treatment. Conclusions The mechanism of AF is very complex， and it’s mecha-nism is still unclear. Clinical management of patients with AF is difficult and controversial， at present， the most effective treatment for AF is operation resection. The effects of adjuvant radiotherapy， chemotherapy， and other treatment after operation for AF still need further study.
ObjectiveTo analyze the correlation between the sarcopenia index (the ratio of creatinine to cystatin C, CCR) and the severity of chronic obstructive pulmonary disease (COPD), and evaluate its potential value as an indicator for auxiliary diagnosis of COPD and assessment of disease severity. Methods A total of 315 patients who underwent pulmonary function tests at Tongren People's Hospital from January 2022 to December 2022 were selected. Among them, 180 patients were diagnosed with COPD, and 135 patients were non-COPD. The COPD group was further divided into GOLD1 group (mild, n=36), GOLD2 group (moderate, n=70), and GOLD3 group (severe, n=74) according to Chronic Obstructive Lung Disease (GOLD) classification. The clinical data, laboratory indicators, and pulmonary function test results of the patients were collected. Correlation analysis was used to explore the correlation between CCR and clinical data. Binary logistic regression analysis was used to explore the influencing factors of COPD. A receiver operating characteristic curve was drawn, and the area under the curve (AUC) was calculated to evaluate the predictive value of CCR for COPD. ResultsAmong the 315 enrolled patients, the prevalence of COPD was 57.14% (180/315). The CCR level of the COPD patients was significantly lower than that of the non-COPD patients. The more severe the condition of COPD patients, the lower the CCR value. The results of Spearman correlation analysis showed that CCR was significantly positively correlated with diffusion capacity of the lung for carbon monoxide, forced expiratory volume in the first second (FEV1) as a percentage of predicted value, FEV1/forced vital capacity, albumin, eosinophils, endogenous creatinine clearance rate, low-density lipoprotein cholesterol, and haemoglobin, and significantly negatively correlated with C-reactive protein, D-dimer, age, and neutrophil to lymphocyte ratio (all P<0.05). Binary logistic regression showed that after adjusting for other relevant factors, CCR was found to be an independent risk factor for the occurrence of COPD (OR=0.902, 95%CI 0.879 - 0.925, P<0.05). When the CCR value was 77.450, the AUC was 0.841 (95%CI 0.798 - 0.885), with a sensitivity of 60.7% and a specificity of 96.1%.ConclusionCCR is closely related to the disease condition and its severity in patients with stable-phase COPD, and it is an independent influencing factor for the occurrence of COPD.