Objective To explore the clinical characteristics and operative methods of the ankle fracture combined with Tillaux-Chaput and Volkmann fractures.Methods The data of 15 patients who were suffered the ankle fracture combined with the simultaneous fractures of Tillaux-Chaput and Volkmann between Septenber 2005 and January 2012 were analyzed.There were 8 males and 7 females with an average age of 27.3 years (range,16-57 years).All had medial malleolar and fibular fracture with Tillaux-Chaput and Volkmann tubercle avulsed fracture.X-ray film shows that there were 8 cases in which the patients had Tillaux-Chaput fracture,among whom 7 were diagnosed by CT scan.Classified by Lauge-Hansen system,ankle fracture could be divided into pronation-exterual rotation type in 4 cases,and pronation-abduction type in 11 cases.The fracture of fibula and the Volkmann tubercle were treated through the posterolateral approach.The fibular fracture was fixed with plate.The medial malleolar fracture was explored from medial curve approach.Tillaux-Chaput fracture was treated by the mierotubule cut.All patients were assessed with the ankle hindfoot clinical rating system of the American Orthopaedic Foot and Ankle Society (AOFAS).Results All patients were followed up for 8-20 months (average,12.5 months).The fracture healed 12-36 weeks later in all the 15 patients,with an average of 23.5 weeks.Twelve patients walked normally and 3 with mild claudication in the last follow-up.The AOFAS score was average 85.4 points,9 were excellent,4 were good,2were fair,with the good-excellent rate being 86.7％ (13/15).The movement of ankle joint limited in 3 patients,tenderness occurred when weight bearing in 3 patients.Conclusion The ankle fracture include the simultaneous fractures of Tillaux-Chaput and Volkmann were more seen in the type of pronation-abduction.It is often misdiagnosis by the photograph; CT scan should be helpful to find the fracture fragments.The exact reduction and stable fixation were needed in the treatment of the ankle fracture combined with Tillaux-Chaput and Volkmann fractures.Inferior tibia fibular screw was not routinely used in this fracture.

OBJECTIVE:To study the synthesis technology of Ligustilide dipolymer (compound Ⅰ). METHODS:Using phthalic anhydride(compoundⅡ)as raw materials,sodium borohydride was reduced to phthalide(compound Ⅲ),and then syn-thesize ligustilide dipolymer after 4 steps. Ligustilide dipolymer was characterized by 1H-NMR and 13C-NMR. The synthesis technol-ogy of fifth step was optimized by orthogonal test with catalyzer,reaction temperature and reaction time as factors using yield as in-dex. The validation test was conducted. RESULTS:The optimal synthesis technology of fifth step was as follows as aluminium mu-riate of catalyzer,reaction temperature of 150 ℃,reaction time of 5 h. The average yield of validation test was 56.16%(RSD=1.23%,n=3). Total reaction yield was 24.4%,and the purity of target product was 99.4%. CONCLUSIONS:Ligustilide dipoly-mer is synthesized successfully;synthetic process is stable,and its quality is controllable.

Objective:To compare the postoperative tunnel enlargement and clinical outcomes of anterior cruciate ligament (ACL) reconstruction using the all-inside technique with the traditional outside-in graft introduction technique.Methods:A retrospective analysis was conducted on 47 patients with ACL injuries who were admitted to the First Hospital of the University of Science and Technology of China between December 2021 and July 2022. The patients were categorized into two groups based on the surgical approach used for ACL reconstruction. There were 25 cases in the all-inside group, 18 males and 7 females, aged 27.72±7.33 years, 17 cases on the left side and 8 cases on the right side; 22 cases in the traditional group, 11 males and 11 females, aged 27.82±7.12 years, 11 cases on the left side and 11 cases on the right side. Clinical parameters including the length of hospital stay, surgical duration, pain levels assessed via the visual analogue scale (VAS), Lysholm score, International Knee Documentation Committee (IKDC) score, and Tegner score were recorded and compared between the two groups. Additionally, femoral and tibial tunnel enlargement was evaluated using postoperative CT scans conducted one year after surgery.Results:All patients were followed up for 15.64±2.04 months (range, 12-21 months). The mean operation time was 178.60±42.90 min in the all-inside group and 133.60±28.77 min in the traditional group, indicating a statistically significant longer operation time in the all-inside group ( P<0.05). On postoperative days 1 and 15, the VAS scores were lower in the all-inside group (7.08±1.29 and 5.56±1.33 points) compared to the conventional group (7.96±1.29 and 6.32±1.13 points), with a statistically significant difference ( P<0.05). However, the differences in VAS scores between the two groups at postoperative months 1, 6, and 12 were not statistically significant ( P>0.05). The preoperative Lysholm, IKDC, and Tegner scores in the all-inside group and the conventional group were 34.00±18.63, 36.24±15.01, 1.20±1.12 points and 36.18±13.64, 38.23±14.94, 1.55±1.14 points, respectively, and at 6 months after surgery, respectively were 72.60±13.95, 74.12±12.03, 3.56±1.05 points, and 68.41±10.80, 66.59±17.93, 3.23±1.15 points, and at 12 months postoperatively were 92.32±5.23, 81.40±7.24, 5.28±1.62 points and 91.27±6.32, 82.18±7.26, 4.96±1.25 points. Both groups improved at 6 months postoperatively compared with preoperatively ( P<0.05), and further improved at 12 months postoperatively compared with 6 months postoperatively ( P<0.05), but the differences in each functional score between the two groups were not statistically significant at all time points ( P>0.05). At 1 year postoperatively, the values of femoral and tibial tunnel enlargement in the all-inside group (1.78±1.03 mm, 1.18±0.97 mm) were smaller than those in the conventional group (2.30±1.33 mm, 1.83±1.00 mm), and the differences were statistically significant ( P<0.05). The difference between the femoral side tunnel enlargement and tibial side enlargement in the traditional group was not statistically significant ( P>0.05), while the femoral side enlargement in the all-inside group was significantly larger than the tibial side ( P<0.05). The difference in Lysholm, IKDC and Tegner scores between grade 0 and grade 1 tunnel enlargement on the femoral side and tibial side was not statistically significant ( P>0.05). Conclusion:The short-term clinical outcomes following ACL reconstruction using the all-inside technique versus the traditional tunnel technique were comparable. However, early postoperative pain was less severe with the all-inside technique, and tunnel enlargement was smaller. The degree of bone tunnel enlargement did not significantly impact early clinical outcomes.

Objective To explore the five-tone distribution of clinical female nurses and the constitution of Traditional Chinese Medicine (TCM). Methods Totally 300 clinical female nurses from a ClassⅢ Grade A hospital were selected. Zhiji Wenyin identification evaluator (KY3H) was used to identify their five tones, and the TCM Constitution Classification and Identification Scale developed by China Association of Chinese Medicine was used to identify their TCM constitution. The five-tone distribution and TCM constitution were compared between the nurses with different ages, job categories and shifts. Results The tones of Jue, Zhi and Yu accounted for 39%, 34% and 21.4% respectively of the five-tone distribution in the 300 clinical female nurses. Divided by age, the tone of Yu was more often found in the younger group, while the tone of Jue had a larger share in the older group (χ2=13.014,4.719; P<0.05). The tones of Yu and Jue were more often found in the night shift group than in the day shift group (χ2=5.902, 3.985; P<0.05). As for the TCM constitution, the mildly, yang-insufficiency, qi-stagnation and damp-heat constitutions accounted for 31.33%, 21.67%, 11.67% and 11.00%, respectively. The nurses in the internal medicine group showed a higher proportion of qi-stagnation and blood-stasis constitutions than the nurses in the surgery group (χ2=6.478, 5.902; P< 0.05). The nurses in the day shift group showed a higher proportion of mildly constitution than the nurses in the night shift group, while the nurses in the night shift group showed a higher proportion of qi-insufficiency constitution than the nurses in the day shift group (χ2=6.210,5.270; P<0.05). The tone of Zhi had the largest share in the nurses with the qi-insufficiency constitution (P=0.002), while the nurses with the qi-stagnation constitution had the least share among the nurses with the tone of Yu (P=0.045). Conclusions The characteristics of five-tone distribution and TCM constitution of clinical female nurses may be affected by their age and job category.

Objective:To investigate the potential effect of hyperopia status on subfoveal choroidal thickness (SFCT) in silicone oil (SO)-filled eyes.Methods:This self-comparative study was conducted in Department of Ophthalmology, Central Theater Command General Hospital. The 50 patients (100 eyes) were collected with unilateral macula-on rhegmatogenous retinal detachment from January 2019 to July 2019, who successfully underwent pars plana vitrectomy (PPV) and SO tamponade. Retinal reattachment was observed after surgery in all patients. One month after PPV, the affected eye was wore soft, contact lenses for 24 hours to correct refractive error (RE), depending on its optometry value. The SFCT of the affected eyes was measured using OCT before and after lenses wear. The fellow eyes also received OCT examination at the same time. T test was used to compare SFCT between SO-filled eyes and fellow eyes.Results:The mean RE of the SO-filled eyes was +6.38±1.12 D. The mean SFCT of SO-filled eyes (247.12±17.63 μm) was significantly thinner than that of the fellow eyes (276.32.55±17.63 μm) ( P<0.001). The SFCT of the SO-filled eyes was significantly thinner than fellow eyes, and the difference was statistically significant ( t=-3.95, P<0.001). After lenses wear, the mean SFCT of the SO-filled eyes increased to 276.32±24.86 μm. Compared with before lenses wear, the difference was statistically significant ( t=-4.30, P<0.001). Compared with the fellow eye, the difference was not statistically significant ( t=0.05, P>0.05). Conclusion:SFCT reduction in the SO-filled eyes may be due to the hyperopia status caused by SO, which can be reserved by RE correction.

Objective:To integrate the best evidence of sexual health management for colorectal cancer patients both domestically and internationally, so as to provide guidance for clinical practice.Methods:Evidence on sexual health management of colorectal cancer patients in domestic and foreign databases and websites was systematically searched, and evidence from literature that met quality evaluation standards was extracted and summarized. The search period was from July 2003 to July 2023.Results:A total of 16 articles were included, including five clinical decisions, six clinical practice guidelines, three expert consensus/group standards, and two systematic reviews. Thirty-four recommended opinions were formed, including eight aspects of evaluation and screening, assessment tools, manifestations of sexual dysfunction, coping strategies for sexual problems, psychological intervention, measures for fertility protection, health education, and follow-up management.Conclusions:This study summarizes the best evidence for sexual health management in colorectal cancer patients. It is necessary to selectively apply evidence based on the evaluation of patient conditions by medical and nursing staff and clinical situations to ensure effective and scientific sexual health management strategies for patients, and promote the translation of best evidence into clinical practice.