两个阶段的蒸发冷却系统在炎艺潮湿气候的应用分析

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Clinical and radiological outcomes after conservative treatment of TB spondylitis: is the 15 years' follow-up in the MRC study long enough?

Introduction: Tuberculosis of the spine is a still a common disease entity, not only in developing countries but is also returning in developed countries especially in the immune-compromised patients. Conservative treatment with chemotherapy is still the main stay of treatment. This article focuses on the clinical and radiological outcomes, and problems with conservative treatment. Method: The available literature of anti-tuberculosis chemotherapy in managing spinal tuberculosis was reviewed. Data sources included relevant literature of the English language identified through Medline search from 1946 to 2011. Personal experience and unpublished reviews from the authors' institution were also included. Results: Although majority of patients respond well to anti-tuberculosis chemotherapy, about 15 % of them develop paradoxical response. The Medical Research Council (MRC) studies have shown that for patients without significant neurological deficits, operative and conservative treatment could produce the same clinical outcome at 15 years follow-up. Patients treated operatively with debridement and spinal fusion with strut graft had faster bony fusion and less kyphotic deformity. In contrast, those treated with drugs alone or with simple debridement without fusion may result in disease reactivation, severe kyphosis or late instability, which in turn may lead to late-onset Pott's paraplegia, back pain, sagittal imbalance and compromised pulmonary function that are difficult or risky to treat. Conclusion: Recognition of the clinical and radiologic features of these late sequels is important for the management. Prevention of deformity in the early disease has been added to the modern standard of treatment of TB spine. © 2012 The Author(s).published_or_final_versionSpringer Open Choice, 25 May 201

The value of radiographs obtained during forced traction under general anaesthesia in predicting flexibility in idiopathic scoliosis with Cobb angles exceeding 60 degree

Our aim in this prospective radiological study was to determine whether the flexibility rate calculated from radiographs obtained during forced traction under general anaesthesia, was better than that of fulcrum-bending radiographs before corrective surgery in predicting the extent of the available correction in patients with idiopathic scoliosis. We evaluated 33 patients with a Cobb angle > 60 degrees on a standing posteroanterior radiograph, who had been treated by posterior correction. Pre-operative standing fulcrum-bending radiographs and those with forced-traction under general anaesthesia were obtained. Post-operative standing radiographs were taken after surgical correction. The mean forced-traction flexibility rate was 55% (SD 11.3) which was significantly higher than the mean fulcrum-bending flexibility rate of 32% (SD 16.1) (p 60 degrees in the standing position and may identify those patients for whom supplementary anterior surgery can be avoided.published_or_final_versio

Cases of Mycobaterium Marinum Tenosynovitis of the hand and wrist: clinical features. management and results

Selected paper for 2010 APOA-Pfizer Best Scientific Paper Award for Orthopaedic InfectionOpen Access JournaleCM XII: Implant Infection Conference Main Focus: Orthopedic and trauma related infectionsAsia Pacific Orthopaedic Association SessionINTRODUCTION: Mycobacterium marinum infections followed an unpredictable clinical course and delay in definitive diagnosis was frequently encountered. Chow et al. found that the average duration of infection before patients were seen by the Orthopaedics unit was 3.3-3.7 months.1 The initial diagnosis was commonly found to be mistaken for conditions such as rheumatoid arthritis and trigger finger which may lead to inappropriate management like steroid injections. The objective of this study was to review our experience with treatment of Mycobacterium marinum tenosynovitis of the hand and wrist and to assess for any clinical parameters that were associated with poor functional outcome and also suggest a treatment algorithm for these …published_or_final_versio

Understanding language teacher's culturally responsive teaching self-efficacy and its enhancement through learning study with young Chinese language learners

Paper Session - SIG L1 Teacher EducationBACKGROUND: Chinese language learners (CLLs) in Hong Kong mainly came from ethnic minorities (EMs) of South Asia. To preclude marginalization, education for EMs became a controversial issue. Frontline Chinese language teachers often encounter difficulties in teaching due to inadequate training. Though teachers play an important role in young CLL’s learning of ...postprin

Prediction of scoliosis correction with thoracic segmental pedicle screw constructs using fulcrum bending radiographs

Award Papers Session: A2Study Design: A retrospective series of 35 idiopathic scoliosis patients underwent spinal fusion with a segmental thoracic pedicle screw system. Objective: To evaluate the amount of scoliosis correction with segmental pedicle screw constructs, and assess whether the fulcrum bending radiograph can predict surgical correction. Summary of Background Data: The fulcrum bending radiograph is highly predictive of actual curve correction based on hook or hybrid systems. However, its predictive value in segmental pedicle screw fixation systems has not been reported. Methods: Patients diagnosed with Lenke type 1A and 1B thoracic idiopathic scoliosis who underwent posterior spinal fusion with segmental pedicle screw constructs by single surgeon from January 2000 to December 2005 were reviewed. The fulcrum flexibility rate (FFR) and correction rate were compared. Stepwise linear regression analysis was done and a prediction equation for the postoperative Cobb angle was developed. Results: Thirty-five consecutive patients were included. Age at surgery was 14.8 years. Twenty scoliosis deformities were flexible, 15 were rigid. All patients had at least 2-year follow-up. The average preoperative Cobb angle was 58°, fulcrum bending Cobb angle was 28°, and postoperative Cobb angle 15° and 16° at 1 month and 2 years, respectively, after surgery. There was significant difference between FFR (51%) and correction rate at 1 month (72%) and 2 year (70%) after surgery. The difference between fulcrum bending corrective index of flexible (122%) and rigid (203%) curves was statistically significant. Stepwise linear regression analysis showed: Predicted postoperative Cobb angle = 0.012 + 1.75 × age - 0.212 × FFR (R = 0.69, P < 0.01). Conclusion: Thoracic pedicle screw constructs achieved better scoliosis correction compared with fulcrum bending radiographs. The fulcrum bending corrective index achieved was significantly greater in rigid than flexible curves. The postoperative Cobb angles could be calculated with a predictive equation. © 2010, Lippincott Williams & Wilkins.postprintThe 29th Annual Congress of the Hong Kong Orthopaedic Association, Hong Kong, 28-29 November 2009. In Spine, 2010, v. 35 n. 5, p. 557-56

Tracking down the migration of mouse neural crest cells

During early embryonic development, cell migration is one of the most important morphogenetic processes. Neural crest cells arise from the dorsal part of the neural tube and migrate along different pathways to numerous locations where they differentiate into a variety of tissues. In the mouse, studies of neural crest cell migration have been difficult partly because of the absence of specific markers which can label neural crest cells throughout their migration from their origin to the site of differentiation. Nevertheless, the use of different experimental strategies involving extrinsic, intrinsic or genetic cell markers has already led to a good understanding of this migration. In our studies, extrinsic markers such as wheat germ agglutinin-gold conjugates and DiI and genetic markers including Hoxb2-lacZ and green fluorescent protein have been employed in tracing migrating neural crest cells. The labelling procedures and the strength and weaknesses of the tracing methods are reviewed herein. Copyright © 2003 S. Karger AG, Basel.published_or_final_versio

Antimicrobial prophylaxis to prevent surgical site infection in adolescent idiopathic scoliosis patients undergoing posterior spinal fusion: 2 doses versus antibiotics till drain removal

PURPOSE: There is much variation in the choice, timing and duration of antimicrobial prophylaxis for preventing surgical site infections (SSI) but no guideline exists for scoliosis surgery. The aim of study was to compare the efficacy of two antimicrobial prophylaxis (AMP) protocols with cephazolin in preventing SSI in adolescent idiopathic scoliosis (AIS). METHODS: A retrospective comparative analysis of two post-operative AMP protocols (two postoperative doses versus continued antibiotics till drain removal) was performed. Patient characteristics, pre-operative, intra- and post-operative risk factors for infection, drain use, generic drug name and number of doses administered were recorded from 226 patients with AIS who had undergone posterior spinal fusion. Details of superficial or deep SSI and wound healing aberrations, and serious adverse events were recorded. Analysis was performed to evaluate differences in the pre-, intra- and post-operative variables between the two groups. RESULTS: 155 patients received 2 postoperative doses of AMP and 71 patients had antibiotics till drain removal. The average follow-up was 43 months. The overall rate of SSI was 1.7 % for the spine wound and 1.3 % for the iliac crest wound. 1.9 % of patients with 2 doses of AMP and 1.4 % of patients with antibiotics till drain removal had SSI. No adverse reactions attributable to cephazolin were observed. CONCLUSIONS: This is the first study on the AMP protocol in scoliosis surgery for SSI prevention. Results suggest that two doses of AMP are as effective as continued antimicrobial use until drain removal. Cephazolin appears to be effective and safe for prophylaxis.postprin

Epidemiology of occupational hand injury in Hong Kong

OBJECTIVES: To study the epidemiology of occupational hand injuries and associated social and industrial factors. DESIGN. For this retrospective case series of patients with occupational hand injuries, case records were retrieved to gather data. In addition, all the subjects were interviewed by a single interviewer using a predesigned questionnaire. SETTING: Division of Hand Surgery, Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong. PATIENTS: A total of 250 patients with occupational hand injuries were treated during the period from 1999 to 2001. This period was chosen to obtain 10 years of follow-up data to assess return to work and any secondary injuries. MAIN OUTCOME MEASURES: Personal particulars (gender, age, marital status, education level, length of stay in Hong Kong, type of employment, wage system, personal habits, family size, number of breadwinners, income), type of industry and mode of injury, causes of injury according to the worker, work conditions, type of injury, and treatment given. RESULTS: Two groups of workers in our study had more occupational hand injuries, namely those with less than 1 year of experience on a new job and immigrants from China. Factors associated with a large proportion of occupational hand injuries were male gender with personal risk factors (smoking and regular consumption of alcohol, long working hours), and in the case of machine operators, inadequate training and use of safety devices. CONCLUSION: Occupational hand injuries lead to loss of working hours and compensation. For prevention, the workplace should be made into a safer and work-friendly environment. Workers should also have sufficient training.published_or_final_versio

Reducing perioperative blood loss and allogeneic blood transfusion in patients undergoing major spine surgery

▶ At present, individual techniques, including intraoperative acute normovolemic hemodilution, use of tranexamic acid, use of intrathecal morphine, proper positioning, and modification of operative techniques, seem most promising for reducing perioperative blood loss and allogeneic blood transfusion in patients undergoing major spine surgery. ▶ Other techniques including preoperative autologous predonation; mandatory discontinuation of use of antiplatelet agents; intraoperative and postoperative red-blood-cell salvage; use of aprotinin, epsilon-aminocaproic acid, recombinant factor VIIa, or desmopressin; induced hypotension; avoidance of hypothermia; and minimally invasive operative techniques require additional studies to either establish their effectiveness or address safety considerations. Copyright © 2011 by The Journal of Bone and Joint Surgery, Incorporated.published_or_final_versio