Objective To investigate complications and mortality of primary reamed intramedullary nailing for femoral shaft fractures in patients a ssociated with thoracic injuries. Methods A retrospective a nalysis of trauma data was performed and the case selection based on the followi ng criteria: (1) patient age of 17-65 years, (2) patients with multiple injury ( ISS≥16) as well as complicated thoracic trauma (AIS≥2), (3) hospitalization stay ≥48 hours, (4)no serious pre-existing medical diseases in history, (5) as sociated femoral shaft fractures treated with reamed intramedullary nailing, ext ernal fixation, plate, cast, traction and unreamed intramedullary nailing. The s elected patients were divided into two groups according to the interval from inj ury to operation, ie, those within 24 hours as Group A and beyond 24 hours as Gr oup B. Results During the study period, 96 patients met the criteria for the investigation. There were 57 patients in the Group A and 39 pa tients in the Group B. In two groups, there was significant difference in incide nce of open femoral shaft fractures (53% in the Group A and 31% in the Group B, ? 2=4.496, P

Objective To explore the curative effects of pulmonary surfactant (PS) injected via venous indwelling needle instead of the endotracheal tube combined with continuous positive airway pressure(CPAP) in the treatment of premature infants with neonatal respiratory distress syndrome (NRDS).Methods 28 premature infants with NRDS were selected,12 cases with gestational age of 28-31 weeks,16 cases with gestational age of 32-34 weeks,and all the cases were treated with PS injected via venous indwelling needle combined with CPAP.The changes in clinical symptoms,blood gas analysis,oxygen saturation,and the parameters of CPAP after treatment were observed.The tracheal intubation in 72h,the second use of PS,respiratory support duration,hospital duration,and the complications between the MIST treatment group and INSURE treatment group were compared.Results There were significant differences in changes of clinical symptoms,percutaneous oxygen saturation,pH,partial pressure of oxyge,partial pressure of carbon dioxide,fraction of inspiration O2 and (positive end expiratory pressure) PEEP after treatment(all P ＜ 0.05).There were statistically significant differences in tracheal intubation in 72h,the second use of PS,complications and respiratory support duration between the MIST group and INSURE group (all P ＜ 0.05).There were no statistically significant differences in bronchopulmonary dysplasia,ROP,PDA,intracranial hemorrhage,and hospital duration (all P ＞ 0.05).Conclusion The therapy of PS injected via venous indwelling needle combined with CPAP in the treatment of premature infants is effective.The method MIST is simple and convenient,has less injury to premature infants,and can reduce frequency and dosage of the PS and respiratory support time.

Objective:To explore superior mediastinal lymph node zoning of thyroid cancer for accurate anatomical definition as a reference for surgical access. Methods:A method for zoning superior mediastinal lymph nodes for thyroid cancer was proposed. From Sep 2018 to Nov 2019, 36 cases of thyroid cancer with superior mediastinal lymph nodes metastases were reviewed. The diagnosis, surgical approaches, pathology, characteristics of lymph node metastasis, complications and follow-up results were analyzed.Results:The superior mediastinal lymph nodes were grouped into 10 areas: 1, 2Ra, 2Rb, 2La, 2Lb, 3A, 3P, 4R, 4La and 4Lb. According to the location of the superior mediastinum metastatic lymph nodes, direct vision approach through the neck incision, laparoscope-assisted approach, thracoscepy, laparoscope-assisted combined with thrascopy approach or conventional median sternotomy was performed for regional lymph node dissection. The average follow-up time was (10±4) months. No residual or recurrence of tumor in superior mediastinal area was found.Conclusions:The zoning of the superior mediastinal lymph nodes in thyroid cancer can be used as a guide for surgical approach to lymph node dissection .