BACKGROUND Diabetes is a common chronic disease,and its global incidence is on the rise.The disease is directly attributed to insufficient insulin efficacy/secretion,and patients are often accompanied by multiple comp...BACKGROUND Diabetes is a common chronic disease,and its global incidence is on the rise.The disease is directly attributed to insufficient insulin efficacy/secretion,and patients are often accompanied by multiple complications.Diabetic foot is one of the most common complications of diabetes.Diabetic feet have ulcers and infections,which can eventually lead to amputation.Basic nursing care,such as lowering blood pressure and preventing foot skin infections in clinical nursing work,has positive significance for the prevention and control of diabetic feet.AIM To explore the positive significance of one-to-one education in high-risk cases of diabetic foot.METHODS This observation included 98 high-risk cases of diabetic foot in our hospital during the period from August 2017 to October 2019,and these patients were randomly divided into the basic nursing group and the one-to-one education group with 49 patients per group.The basic nursing group only received routine basic nursing,while the one-to-one education group gave patients one-to-one education on the basis of basic nursing.After nursing,the self-care ability and compliance behavior of the two groups were evaluated and compared between these two groups.The knowledge mastery of the patient and the satisfaction of nursing were accounted.RESULTS The assessment results of patients(self-care responsibility,self-care skills,selfconcept and self-care knowledge)were significantly higher in the one-to-one education group than in the basic nursing group.The scores of compliance behaviors(foot bathing,shoes and socks selection,sports health care)in the oneto-one education group were significantly higher than those in the basic nursing group.Patients in the one-to-one education group had a significantly higher level of knowledge mastery and satisfaction of nursing than the basic nursing group.CONCLUSION One-to-one education for high-risk cases of diabetic foot is helpful to improve the cognition and self-care ability of patients with diabetic foot,to ensure that patients follow the doctor’s advice of self-care and to improve their nursing satisfaction.展开更多
BACKGROUND Primary synovial chondromatosis(PSC) is a rare arthropathy of the synovial joints characterized by the formation of cartilaginous nodules, which may detach and become loose bodies within the joint and may u...BACKGROUND Primary synovial chondromatosis(PSC) is a rare arthropathy of the synovial joints characterized by the formation of cartilaginous nodules, which may detach and become loose bodies within the joint and may undergo secondary proliferation. PSC of the foot and ankle is exceedingly rare, with only a few cases reported in the literature. The diagnosis may be difficult and delayed until operative treatment, when it is confirmed by histological assessment. PSC may degenerate into chondrosarcoma. Operative treatment is the gold standard aiming to minimize pain, improve function, prevent or limit progression of arthritis. Surgical treatment consists in debridement by arthrotomic or arthroscopic management, but there is no consensus in the literature about timing of surgery and surgical technique. Thus, the aim of this study is to report the outcomes of the surgical treatment of two cases, together with a literature review.CASE SUMMARY We report two cases of patients affected by PSC of the foot in stage III, according to the Milgram classification: the former PSC localized in the ankle that underwent open surgery consisted of loose bodies removal;the latter in the subtalar joint, and the choice of treatment was the arthrotomy and debridement from loose bodies, in addition to the subtalar arthrodesis. Both patients returned to complete daily and working life after surgery.CONCLUSION Synovial chondromatosis is a rare benign pathology, even rarer in the ankle joint and especially in the foot. Surgery should be minimal in patients with ankle PSC,choosing the correct timing, waiting if possible until stage III. More aggressive and early surgery should be performed in patients with PSC of the foot,particularly the subtalar joint, due to the high risk of arthritic evolution.展开更多
BACKGROUND Cleft foot is a very rare congenital anomaly,which is characterized by central rays deficiency of the foot.It is also known as split foot or ectrodactyly of the foot,and it is very often combined with split...BACKGROUND Cleft foot is a very rare congenital anomaly,which is characterized by central rays deficiency of the foot.It is also known as split foot or ectrodactyly of the foot,and it is very often combined with splitting of the hands.The defect develops due to insufficient activity of the median apical ectodermal ridge,which leads to an increase in cell death or a decrease in cell proliferation.Due to the rarity of the pathology,there are few papers on the surgical treatment of this congenital foot disease,and publications to date concern the treatment of children.CASE SUMMARY We present a clinical case of congenital splitting of the feet and hands in a 31-year-old woman and a long-term result of foot treatment using the minimal arrangement of the Ilizarov apparatus.The patient had paternal inheritance of the trait.After the surgical treatment,cosmetic view and functional condition of the foot were improved and persisted two years after intervention.There were no complications in the treatment process.CONCLUSION The possibility of dosed control and stable fixation of the foot rays made it possible to create favorable conditions for the healing of the central wound and the closure of the segment splitting without complications.The long-term outcome of the treatment of foot congenital splitting using the proposed Ilizarov apparatus arrangement has shown its effectiveness.Our approach should be considered as an option of treatment in similar cases.展开更多
BACKGROUND Lisfranc injuries are rare and can be easily missed. This injury is extremely rare in children, with limited published data. Different treatment options have been described; one of the options in adults is ...BACKGROUND Lisfranc injuries are rare and can be easily missed. This injury is extremely rare in children, with limited published data. Different treatment options have been described; one of the options in adults is the "mini" TightRope^(TM) Syndesmosis Device that provides non-rigid fixation with impressive results. However, there is no reference regarding the use of this device in children.CASE SUMMARY We describe the case of an 11-year-old girl who sustained a Lisfranc injury of her right foot that was initially missed in the Accident and Emergency department of her local hospital. This case was a ligamentous/periosteal sleeve avulsion type of Lisfranc injury and a percutaneous technique using the "mini" TightRope^(TM)syndesmosis device was used. Clinical and radiological results were excellent at final follow up.CONCLUSION The "mini" TightRope^(TM) syndesmosis device is a promising method of fixation for children with certain Lisfranc injuries. This method has many advantages,including the non-rigid type of the fixation and no need for subsequent metalwork removal.展开更多
Objective To analyze the clinical and laboratory features of patients with mild and severe HFMD to identify early predictive or diagnostic markers for severe cases. Methods Samples of feces, nasopharyngeal-swab specim...Objective To analyze the clinical and laboratory features of patients with mild and severe HFMD to identify early predictive or diagnostic markers for severe cases. Methods Samples of feces, nasopharyngeal-swab specimens, peripheral blood, serum and cerebral spinal fluid were collected. Postmortem pathological examination was conducted on 2 dead patients with complication due to neurogenic pulmonary edema. Reverse transcription-polymerase chain-reaction(RT-PCR), culture and isolation of enterovirus 71(EV71) were performed to detect EV71 infection. Both univariate and multivariate logistic analysis were used to identify factors associated with severe cases. Results EV71 was mainly responsible for HFMD. In this study, 5 isolated EV71 strains belonged to C4 gene subtype. Compared with mild patients, EV71-RNA detection rate was higher and Cox A16 detection rate was lower among severe patients(P < 0.01). Inflammatory cell infiltration in the lung, cardiac and liver tissues were mild by postmortem pathological examination. It was found that body temperature, vomitting, limb tremor, neutrophil, blood glucose and EV71 infection were significantly related to the severe cases by univariate logistic analysis. However, after multivariate logistic regression analysis, only vomiting(OR 16.1, CI 2.3-110.5, P < 0.01) and limb tremor(OR 117.6, CI 13.8-1004.5, P < 0.01) were significantly and independently correlated with the severe cases.Conclusions EV71 was mainly responsible for HFMD, particularly for severe cases. Vomiting and limb tremor were predictive markers for severe cases.展开更多
基金Supported by Medical Science and Technology Research Foundation of Guangdong Province,No.A2018461.
文摘BACKGROUND Diabetes is a common chronic disease,and its global incidence is on the rise.The disease is directly attributed to insufficient insulin efficacy/secretion,and patients are often accompanied by multiple complications.Diabetic foot is one of the most common complications of diabetes.Diabetic feet have ulcers and infections,which can eventually lead to amputation.Basic nursing care,such as lowering blood pressure and preventing foot skin infections in clinical nursing work,has positive significance for the prevention and control of diabetic feet.AIM To explore the positive significance of one-to-one education in high-risk cases of diabetic foot.METHODS This observation included 98 high-risk cases of diabetic foot in our hospital during the period from August 2017 to October 2019,and these patients were randomly divided into the basic nursing group and the one-to-one education group with 49 patients per group.The basic nursing group only received routine basic nursing,while the one-to-one education group gave patients one-to-one education on the basis of basic nursing.After nursing,the self-care ability and compliance behavior of the two groups were evaluated and compared between these two groups.The knowledge mastery of the patient and the satisfaction of nursing were accounted.RESULTS The assessment results of patients(self-care responsibility,self-care skills,selfconcept and self-care knowledge)were significantly higher in the one-to-one education group than in the basic nursing group.The scores of compliance behaviors(foot bathing,shoes and socks selection,sports health care)in the oneto-one education group were significantly higher than those in the basic nursing group.Patients in the one-to-one education group had a significantly higher level of knowledge mastery and satisfaction of nursing than the basic nursing group.CONCLUSION One-to-one education for high-risk cases of diabetic foot is helpful to improve the cognition and self-care ability of patients with diabetic foot,to ensure that patients follow the doctor’s advice of self-care and to improve their nursing satisfaction.
文摘BACKGROUND Primary synovial chondromatosis(PSC) is a rare arthropathy of the synovial joints characterized by the formation of cartilaginous nodules, which may detach and become loose bodies within the joint and may undergo secondary proliferation. PSC of the foot and ankle is exceedingly rare, with only a few cases reported in the literature. The diagnosis may be difficult and delayed until operative treatment, when it is confirmed by histological assessment. PSC may degenerate into chondrosarcoma. Operative treatment is the gold standard aiming to minimize pain, improve function, prevent or limit progression of arthritis. Surgical treatment consists in debridement by arthrotomic or arthroscopic management, but there is no consensus in the literature about timing of surgery and surgical technique. Thus, the aim of this study is to report the outcomes of the surgical treatment of two cases, together with a literature review.CASE SUMMARY We report two cases of patients affected by PSC of the foot in stage III, according to the Milgram classification: the former PSC localized in the ankle that underwent open surgery consisted of loose bodies removal;the latter in the subtalar joint, and the choice of treatment was the arthrotomy and debridement from loose bodies, in addition to the subtalar arthrodesis. Both patients returned to complete daily and working life after surgery.CONCLUSION Synovial chondromatosis is a rare benign pathology, even rarer in the ankle joint and especially in the foot. Surgery should be minimal in patients with ankle PSC,choosing the correct timing, waiting if possible until stage III. More aggressive and early surgery should be performed in patients with PSC of the foot,particularly the subtalar joint, due to the high risk of arthritic evolution.
文摘BACKGROUND Cleft foot is a very rare congenital anomaly,which is characterized by central rays deficiency of the foot.It is also known as split foot or ectrodactyly of the foot,and it is very often combined with splitting of the hands.The defect develops due to insufficient activity of the median apical ectodermal ridge,which leads to an increase in cell death or a decrease in cell proliferation.Due to the rarity of the pathology,there are few papers on the surgical treatment of this congenital foot disease,and publications to date concern the treatment of children.CASE SUMMARY We present a clinical case of congenital splitting of the feet and hands in a 31-year-old woman and a long-term result of foot treatment using the minimal arrangement of the Ilizarov apparatus.The patient had paternal inheritance of the trait.After the surgical treatment,cosmetic view and functional condition of the foot were improved and persisted two years after intervention.There were no complications in the treatment process.CONCLUSION The possibility of dosed control and stable fixation of the foot rays made it possible to create favorable conditions for the healing of the central wound and the closure of the segment splitting without complications.The long-term outcome of the treatment of foot congenital splitting using the proposed Ilizarov apparatus arrangement has shown its effectiveness.Our approach should be considered as an option of treatment in similar cases.
文摘BACKGROUND Lisfranc injuries are rare and can be easily missed. This injury is extremely rare in children, with limited published data. Different treatment options have been described; one of the options in adults is the "mini" TightRope^(TM) Syndesmosis Device that provides non-rigid fixation with impressive results. However, there is no reference regarding the use of this device in children.CASE SUMMARY We describe the case of an 11-year-old girl who sustained a Lisfranc injury of her right foot that was initially missed in the Accident and Emergency department of her local hospital. This case was a ligamentous/periosteal sleeve avulsion type of Lisfranc injury and a percutaneous technique using the "mini" TightRope^(TM)syndesmosis device was used. Clinical and radiological results were excellent at final follow up.CONCLUSION The "mini" TightRope^(TM) syndesmosis device is a promising method of fixation for children with certain Lisfranc injuries. This method has many advantages,including the non-rigid type of the fixation and no need for subsequent metalwork removal.
基金supported by a 2009 National Natural Sciences of Foundation of The People’s Republic of China (NSFC 30972603)
文摘Objective To analyze the clinical and laboratory features of patients with mild and severe HFMD to identify early predictive or diagnostic markers for severe cases. Methods Samples of feces, nasopharyngeal-swab specimens, peripheral blood, serum and cerebral spinal fluid were collected. Postmortem pathological examination was conducted on 2 dead patients with complication due to neurogenic pulmonary edema. Reverse transcription-polymerase chain-reaction(RT-PCR), culture and isolation of enterovirus 71(EV71) were performed to detect EV71 infection. Both univariate and multivariate logistic analysis were used to identify factors associated with severe cases. Results EV71 was mainly responsible for HFMD. In this study, 5 isolated EV71 strains belonged to C4 gene subtype. Compared with mild patients, EV71-RNA detection rate was higher and Cox A16 detection rate was lower among severe patients(P < 0.01). Inflammatory cell infiltration in the lung, cardiac and liver tissues were mild by postmortem pathological examination. It was found that body temperature, vomitting, limb tremor, neutrophil, blood glucose and EV71 infection were significantly related to the severe cases by univariate logistic analysis. However, after multivariate logistic regression analysis, only vomiting(OR 16.1, CI 2.3-110.5, P < 0.01) and limb tremor(OR 117.6, CI 13.8-1004.5, P < 0.01) were significantly and independently correlated with the severe cases.Conclusions EV71 was mainly responsible for HFMD, particularly for severe cases. Vomiting and limb tremor were predictive markers for severe cases.
