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Malignant tumors of digestive system mainly include gastric cancer, colorectal cancer, and esophageal cancer, which generally need chemotherapy. PICC refers to peripherally inserted central venous catheter, which plays an important role in the treatment of malignant tumor patients with chemotherapy, and it has the characteristics of high success rate of puncture and reducing the pain of patients. Its principle is to use PICC catheter for drug delivery, which can effectively reduce the pain of tumor patients for multiple puncture, and also can avoid drug extravasation or local stimulation of drugs. However, PICC catheter-related complications cannot be ignored, to some extent, directly affect the treatment effect of patients, and increase the pain and burden of patients. Therefore, this paper proposes a study of PICC catheter-related complications and protective nursing for patients with digestive system cancer based on smart medical block chain. First of all, using the method of literature, this paper deeply studied the combination of smart medicine and block chain and further strengthened the research on PICC catheter-related complications. Based on this, we designed a study on the prevention and nursing of PICC catheter-related complications in patients with digestive system cancer. Before the implementation of nursing, the incidence of complications in patients with digestive system cancer was 17.35%; after the implementation of nursing, the incidence of complications decreased to 4.08%. The purpose of this study is to analyze the causes through clinical research and put forward the protective nursing measures of related diseases, so as to reduce the incidence of PICC-related complications.Cystic echinococcosis is a widely endemic helminthic disease worldwide but occurs only rarely in Central Europe. GS-441524 Humans are infected as 'aberrant' hosts by Echinococcus granulosus and develop cysts in numerous different organs. 20%-30% of the affected individuals develop hydatid disease in the lungs with associated complications including pleuritis, lung abscess and pneumothorax. Radiologically, the pulmonary lesions of cystic echinococcosis occasionally pose difficulties in the differential diagnosis of primary lung carcinoma or metastatic disease and vice versa. Herein we report on a case of pulmonary hydatid disease in a 25-year-old Iraqi male presenting with a cystic lesion of the lung associated with thoracic pain and involuntary weight loss. Despite of its rare occurrence in Central Europe, clinicians, radiologists and pathologists should be aware of this entity and its pulmonary manifestations. During frozen section examination, imprint cytology specimens may facilitate the detection of the pathogens.Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor that may arise in bone. The purpose of this investigation was to determine the clinicopathological features and outcomes of osseous EHE in a large patient series, and to assess whether survival is impacted by demographics, tumor characteristics, or treatment factors. This was a retrospective review of the Surveillance, Epidemiology and End Results (SEER) database from 1992 to 2016. Kaplan-Meier was used to estimate overall survival (OS) and disease-specific survival (DSS). A Cox regression model was used to identify prognostic factors. Fifty patients from 1992 to 2016 with a median age of 54.5 years (IQR, 37-67) were reviewed. For location, 46% (n = 23) of tumors arose from the appendicular skeleton while 38% (n = 19) occurred within the axial skeleton (overlapping EHE 16%, n = 8). Of the cases with recorded treatment factors, 54.8% (n = 23) had surgery, 26% (n = 13) received radiation, 22% (n = 11) were treated with chemotherapy, and 26% (n = 13) had surgery plus radiation. The 5-year OS probability was 49.2% (95% CI, 23.6-70.6), and the 5-year DSS probability was 63.9% (95% CI, 33.0-83.5). No surgery (surgery HR, 0.262; 95% CI, 0.07-0.9); p = 0.041) and age older than 50 years (HR, 4.117; 95% CI, 1.1-15.4; p = 0.035) were negative prognostic factors of disease-specific mortality after controlling for confounding variables. There was no association between disease-specific mortality and adjuvant or multimodal therapy. The prognosis of EHE of bone is less than favorable, and the 5-year DSS probability of 64% emphasizes the intermediate grade nature of this tumor subtype. Surgical treatment, when feasible, is associated with a better prognosis.Basketball is a popular internationally played sport. With the physical requirements the game has on athletes, players are at risk of injury. Ankle injuries are the most common injury type suffered by basketball players. In this comprehensive review, we present an analysis and overview of the most common ankle injuries among basketball players, including sprains, fractures, impingement, and Achilles tendon pathology. The review includes treatment modalities for such injuries. More research is warranted regarding prevention strategies.The purposes of this study were to demonstrate the clinical characteristics of patients with persistent second carpometacarpal (CMC) joint pain without bony abnormalities known as the carpal boss, and to assess the clinical efficacy of surgical stabilization of the second CMC joint. Eleven patients had persistent wrist pain with characteristic symptoms, including tenderness over the second CMC joint, increased symptoms when the involved hand was placed on the ground or gripped strongly with the involved hand, a positive metacarpal stress test and temporary pain relief with the intra-articular injection of the lidocaine. The patients underwent arthrodesis of the second CMC joint. All cases showed radiologically confirmed fusion of the second CMC joint. At the final followup examination, 10 of 11 patients resulted in satisfactory clinical outcomes, excepting one patient with remnant pain and restricted range of wrist motions. This report highlights the importance of conducting a careful assessment of patients who present with persistent second CMC joint pain without the bony abnormalities, such as carpal bossing. Surgery to stabilize the second CMC joint may be an option to improve their symptoms when conservative treatment fails.Regardless of prognosis, surgery is often considered in metastatic bone disease (MBD) as a palliative procedure to improve function and quality of life. Traditional focus on objective outcomes such as mortality is inappropriate in this group, and there is a drive to assess outcomes via patient-reported outcome measures (PROMs). This is an overview of current understanding of MBD outcomes and how this should influence future decision-making and research. The objectives of this review were to identify difficulties in measuring PROMs in the MBD patient population and explore alternatives to patientreported outcomes. We also provide an overview of current understanding of outcomes in MBD and how this should influence decision-making and direct research.The aim of this retrospective cohort study was to investigate the effect of BMI on 1-year functional outcome, quality of life (QoL) and rate of postoperative complications after shoulder arthroplasty. We included 121 patients (59 men and 62 women) with primary osteoarthritis (OA) who underwent anatomical or reverse total shoulder arthroplasty (TSA or rTSA) between 2011 and 2016. Age, sex, preoperative BMI, preoperative medical status using American score of anesthesiologists (ASA) class, type of prosthesis, preoperative and 1-year postoperative functional outcome using the Constant score and quality of life (QoL) using the EQ-5D as well as postoperative complication rate were documented. Patients were divided into three groups based on their BMI, group 1 (normal weight, BMI BMI 30). All three groups were comparable regarding age, sex and ASA class, preoperative Constant score EQ-5D. We found significant improvement of the Constant score and EQ- 5D at 1-year postoperative follow-up, regardless of BMI (p less then 0.05). Comparing the three groups, we found no significant differences among them in 1-year Constant score, EQ-5D or postoperative rate of complications. This study showed that BMI did not affect functional outcome, QoL and postoperative complication rate in TSA. These results can help physicians and patients to make reasonable perioperative expectations and planning.Avulsions of the volar plate of the finger proximal interphalangeal joint (PIPJ) following sprains are often undiagnosed in the acute setting. Therefore, the chronic outcomes of this injury are most frequently the object of study and treatment. Different techniques for volar plate chronic avulsion repair are described in the literature. The most used among these are mainly two the direct suturing with or without the use of bone anchors and the tenodesis techniques with flexor digitalis superficialis (FDS). The aim of this systematic review is to determine outcomes and complications associated with these surgical treatments of post-traumatic volar plate avulsions without phalangeal fractures. An electronic literature research was carried out and pertinent articles were selected. Surgical techniques details, outcomes and complications for direct sutures and tenodesis technique are discussed. Outcomes (Range of motion and pain) seem to be comparable, whereas authors that use the direct suture technique describe more frequently PIPJ flexion contracture complication. From this review of the literature, authors believe that both techniques are available for the repair of chronic injuries of the volar plate of the PIPJ, although direct suturing can be considered as less reproducible.This observational study aims to assess the impact of the COVID-19 pandemic on orthopaedic patients' psychology and clinical management, focusing on gender differences in the following items (1) pain perception and therapeutic compliance during the pandemic, compared with the pre-pandemic period; (2) relationship doctorpatient (considering both general practitioners and orthopaedic surgeons); (3) patient referral to Orthopaedic emergency room. An Ad Hoc online questionnaire was developed and administered to patients referring to Orthopaedic emergency departments and Orthopaedic outpatient departments throughout Italy, between March and April 2020. The patients' psychological status during the pandemic was evaluated, mainly focusing on the following aspects, i.e., the fear of contracting the COVID-19 infection, the perceived risk of COVID-19 contagion and the compliance with the COVID-19 restrictions. Differences between genders were also assessed. 782 patients finally took part in the present study. A significant decrease of general practitioner and Orthopaedic surgeon clinical referral was recorded during the lockdown period, compared with pre-COVID period (p less then 0.001; p=0.031). Nonetheless, the number of phone calls to the general practitioner did not undergo substantial differences (p=0.093), compared to patients' the phone consult with orthopaedic surgeons (p=0.042). A significant correlation was found between the fear of COVID-19 contagion the perceived risk of contracting the infection (p less then 0.001). The COVID pandemic significantly impacted on orthopaedic patients' psychology and perception of the disease. During the lockdown, patients gave a higher priority to the pandemic event and significantly reduced the treatment of their orthopaedic disease.

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