Literatures about patella fracture fixation in recent years are analyzed retrospectively in this paper.Its characteristics and therapeutic purpose are investigated.A series of new type of internal fixations and external fixations are emphasized.

Objective To investigate the clinical efficacy of polysaccharide iron combined with folic acid in treatment of anemia in gestation women and its effect on neonatal outcomes.Methods 82 cases of pregnant women with iron deficiency anemia were selected and randomly divided into two groups, each had 41 cases.All patients received discontinuation of iron supplementation two weeks pre-treatment, control group received compound ferrous sulfate and folic Acid Tablets (4 tablets, tid), the treatment group received with Iron Polysaccharide Complex Capsules (0.15 g~0.30 g, qd) and Folic Acid Tablets (0.4 m, qd) .Levels of serum Hb, SF and SI between two groups were compared, and the pregnancy outcomes, neonatal outcomes, and effect and safety were observed.Results Compared with pre-treatment, levels of RBC, HCT and Ret, levels of Hb, SF and SI in two groups were all increased (P<0.05),and those indexes in treatment group were higher than control group (P<0.05).Compared with control group, birth outcomes in cesarean section, the rate of postpartum hemorrhage and neonatal distress rate in treatment group were lower (P<0.05), scores of neonatal muscle tension, pulse, respiration, skin frowning were higher ( P <0.05 ), the total efficiency and safety were higher ( P <0.05 ). Conclusion Polysaccharide iron combined with folic acid in treatment of anemia in gestation women was accurate , it can significantly improve the neonatal outcomes.

Objective To establish musculoskeletal model and finite element model of kidney and blood stasis type knee osteoarthritis (KOA),and to analyze the cartilage stress characteristics of kidney and blood stasis type KOA.Methods Data from knee CT,MRI of kidney and blood stasis type KOA volunteers was used to construct musculoskeletal model and finite element model based on AnyBody and ANSYS software.Surface electromyogram (sEMG) verification and mutual verification were conducted.KOA bone stress and strain parameters were observed at the moving angles of 0°,-40°,-90°,-180° of the KOA musculoskeletal model,in order to explore the cartilage stress characteristics.Results When the positions of kidney and blood stasis type KOA patients varied from standing to squatting,the knee cartilage surface stress revealed a nonlinear increasing trend.Kidney and blood stasis KOA patient's knee cartilage stress near the distal end was significant different from that of normal subjects (P＜0.05),while the KOA patient's knee cartilage stress near the distal end and proximal front side had no significant differences with that of normal subjects (P＞0.05).Conclusions For kidney and blood stasis type of patients with KOA,cartilage surface stress displays a nonlinear increasing trend along with the stress concentration at the motion cartilage surface,which is consistent with the clinical features.

Objective To discuss external fixation method for the complex diaphyses fracture involving condyles of femur and evaluate its clinical efficacy.Methods A retrospective study was done on 42 patietns with comminuted femur diaphyses fracture combined with distal intra-articular fractures treated surgically from January 2001 to Janurary 2007.There were 24 males and 18 females at mean age of 33 years (20-66 years).According to AO/ASIF classification,there were 18 patients with type C2 fractures and 24 with type C3 ones.Simple internal fixation plus external fixation was performed on patitents with C3 fractures but only external fixation on those with C2 fractures.Four patients were treated with intramedular fixation.Results All patients were followed up for 1-12 months.According to Kotmert's assessment standard on function of proximal femur,the knee function was satisfactory in 35 patients (83% ) ,good in six (14% ) and unsatisfactory in one (2% ).Conclusions Minimally invasive external fixation can utmostly restore relative length of the femur and regulate between articular face of the femur and longitudinal axis of femur shaft to reach a symmetrical relation with middle and inferior part of opposite femur.Postoperative exercise is important for maximal recovery of the knee function.Attention should be paid to reconstruction of tubiform structure of the femur.

ObjectiveTo explore the changes and significances of cardiac troponin Ⅰ (cTnⅠ),myoglobin (Mb) and creatine kinase MB (CK-MB) in old patients with acute myocardial infarction(AMI).MethodThe levels of cTnⅠ, Mb and CK-MB in 89 cases with AMI patients (AMI group) and 100 healthy controls (control group) were detected and compared. ResultsThe levels of cTnⅠ, Mb and CK-MB in AMI group were ( 8.15 + 3.26) μ g/L, (478.45 ± 96.87 ) μ g/L and ( 128.17 ± 53.26 ) U/L, while were (0.03 ±0.02) μ g/L, (21.61 + 9.38 ) μ g/L and (9.53 ± 2.94) U/L in control group, the levels of cTnⅠ, Mb and CK-MB in AMI group were significantly higher than those in control group(P ＜ 0.05 ). The sensitivity rate of cTnⅠ,Mb and CK-MB for detecting AMI was 95.5％ (85/89), 97.8％ (87/89) and 87.6％ (78/89), and the specificity rate was 98.0％(98/100), 82.0％(82/100) and 94.0％(94/100). ConclusionThe levels of cTnⅠ, Mb and CK-MB are significantly increased in AMI patients, which cTnⅠ for detecting AMI has high sensitivity and specificity.

Objective To explore the psychological status of patients after hand tenolysis and the pertinent nursing countermeasures. Methods 47 patients after hand tenolyais were selected and investigated their psychological status and relevant influencing factors with serf-designed questionnaire and symptom checklist-90(SCL-90). Besides, corresponding psychological nursing were applied. The SCL-90 results of Chinese Norm were adopted to undergo comparison with them and t test was chosen. Results On the first day after operation, the score of the investigation objectives was significantly different compared with that of the Chinese norm. After pertinent mental nursing, their symptoms alleviated, and no significant difference was seen between them. Conclusions There are obvious psychological obstacles in patients after hand tenolysis. The pertinent mental nursing has important effect on rehabilitation training and functional rehabilitation after hand tenolysis.

Mechanosensitive ion channels are mechanoreceptors that convert mechanical stimulation on the cell surface into intracellular electrical signal or chemical signal. In recent years, Piezo protein as a mechanically activated cation channel in eukaryotes has gradually become a research hotspot. Piezo1 and Piezo2 proteins are expressed in different organs and tissues of mammals, and tissues such as bones and joints are directly related to mechanical conduction. The intracellular effects caused by the conduction of mechanical force play a very important role in the treatment and prevention of orthopedic diseases. In this paper, the researches on Piezo protein mechanically activated cation channels in bone tissue, cartilage tissue, bone marrow tissue, intervertebral disc tissue and orthopedic diseases were reviewed.

Objective:To explore the reliability of Xpert MTB/RIF (Xpert) in the diagnosis of pulmonary tuberculosis and to understand the characteristics of retreated patients, so as to provide clues for the investigation of retreated patients.Methods:905 patients sputum with suspected tuberculosis from July 2019 to December 2019 were collected from the Tuberculosis Department of Changsha Central Hospital. Xpert was used for rapid screening of tuberculosis. MGIT960 and Roche culture method were used for rapid sputum culture and drug sensitivity, respectively. Rifampin (RIF) resistance was compared between Xpert and Roche culture. The gender, age, RIF resistance, occupation and diabetes mellitus of patients with positive Xpert were compared, and the risk factors of RIF resistance were analyzed by binary logistic regression.Results:The total detection rate of Xpert was 28.7%(260/905) in 905 suspected pulmonary tuberculosis patients; RIF resistance rate accounted for 20.8%(54/260) in 260 positive patients, and the main mutation types were probe-E and probe-D. There was no significant difference between traditional drug sensitivity and Xpert method in RIF resistance detection ( P>0.05); There was no significant difference between Xpert method and traditional drug sensitive cases in predicting isoniazid (INH) resistance ( P=0.293); there were significant differences in age ( t=-3.835, P<0.05), gender, RIF resistance rate and proportion of farmers between newly treated and retreated patients (χ 2=5.091, 16.862, 4.808, P<0.05); Binary logistic regression showed that retreatment was a risk factor for RIF resistance ( OR=3.739, P=0.004). Conclusions:Xpert has high clinical value in the diagnosis of pulmonary tuberculosis and RIF resistance; The retreated patients were older, and the proportion of male farmers was larger, with higher resistance rate to RIF.

OBJECTIVE:To investigate the use of prophylactic use of antibiotics for special diagnosis and treatment in our hos-pital,and to provide reference for rational use of antibiotics. METHODS:The patients receiving special diagnosis and treatment were collected from our hospital during Jan.-Aug. 2016. The prophylactic application of antibiotics was analyzed statistically. RE-SULTS:Among 149 included patients,there were 62 cases of prophylactic use of antibiotics with utilization rate of 41.61％. Among 62 patients receiving antibiotics,5 cases were given medicine orally and others were via injection. Nine categories 18 types of antibiotics were used,involving 69 times;cephalosporin were used in 49 times(71.01％),among which top 3 types in the list of use sequence were cefodizime,cefotetan and cefazolin;prophylactic use of antibiotics was not found in angiography(including coronary artery) and stent implantation. Utilization rate of antibiotics for other diagnosis and treatment was more than 50％. The prophylactic use of antibiotics was complex in ureteroscopy and cystoscopy,shock wave lithotripsy;the selection of drug types started from the high level. There were 59 cases of single drug(95.16％)and 3 cases of two-drug(4.84％). Total of 41 cases were given medicine 0.5-2 h before surgery or at the beginning of anaesthesia (66.13％). Medication time of 18 cases was ≤24 h (29.03％);that of 11 cases was >24-48 h(17.74％). CONCLUSIONS:The prophylactic use of antibiotics is relatively standard in angiography(including coronary artery),stent implantation and implantation of peritoneal dialysis tube in our hospital. There are some problems during special diagnosis and treatment,such as the indication of drug delivery is not strict;the selection of drug types starts from the high level;medication timing is not suitable;medication course is excessively long.

Objective To explore the effect of minimally invasive pedicle screw fixation for the treatment of thoracolumbar spine fracture.Methods Totally 80 patients with thoracolumbar spinal fracture accepted pedicle screw internal fixation in our hospital from January 2012 to December 2015 were selected as the observation object.According to the operation mode,they were equally divided into minimally invasive surgery group and open surgery group.The operation effect,quality of life and the incidence of complications of the two groups were compared.Results The operation time of the two groups had no significant difference.The amount of blood loss and postoperative drainage volume in minimally invasive surgery group were less than those in open surgery group(P ＜ 0.05).The anterior and posterior Cobb's angles of the two groups had no significant difference.The anterior and posterior Cobb's angles of the two groups both decreased 3 months after operation,and it decreased more significantly in the minimally invasive surgery group compared with the open surgery group with statistically significant difference(P ＜0.05).The VAS and ODI scores between the two groups had no significant difference before operation.And the scores of the two groups all decreased 3 months after operation,but the reduction in the minimally invasive surgery group was more significant (P ＜ 0.05).The incidence rate of complications of the two groups had no significant difference (P ＞ 0.05).The quality of life of the two groups had no difference before surgery,and it increased 3 months after the operation both in the two groups,and the minimally invasive surgery group increased more significantly (P ＜ 0.05).Conclusion The minimally invasive pedicle screw internal fixation for thoracolumbar spine fracture has a better therapeutic effect,which can significantly improve the patients clinical symptoms,signs,and their quality of life.