Objective To analyze the clinical methods of type Ⅲ Pilon fracture internal fixation. Methods The internal fixation with steel plate were performed in 36 cases with Ruedi-AllgoWer type, Ⅲ Pilon fracture and all patients had early post-operative rehabilitation functional exercise. Results Thirty-six cases were followed up for an average period of 16 months. The fracture healed completely in all cases and the successful rates of good function reached 88.9% (32/36) according to YU Guang-rong's evaluation standard. Conclusion For Ruedi-AUgower type Ⅲ Pilon fracture, appropriate surgical time combined with internal fixation with steel plate and early post-operative function exercise showed satisfactory therapeutic effect.

Objective To investigate the effect of the locking plate fixation with anti-osteoporosis drug in the treatment of older patients with proximal humeral fractures. Methods Sixty-two patients with proximal humeral fractures who were treated in Yuzhou Mining Company Hospital of Kailuan Group of Hebei Province from Feb. 2011 to Oct. 2013 were divided into observation group(n=30)and control group(n=32). Patients in both groups were given locking plate fixation,and patients in the observer group were also received anti-osteoporosis treatment. The information including hospitalization periods,efficacy and bone mineral density of the two groups was recorded. Results The hospitalization periods of the observation group and control group were (6. 9 ± 1. 0)d,(9. 5 ± 1. 1)d,and the difference was statistically significant(t=8. 426,P﹤0. 05). The efficacy in observer group was excellent in 17 cases,good in 10 cases,fair in 2 cases and poor in 1 case,and the efficacy of the control group was excellent in 14 cases,good in 10 cases,fair in 5 cases and poor in 3 cases. The difference was statistically significant(χ2 =4. 617,P ﹤0. 05 ). After the anti-osteoporosis treatment,the bone mineral density of the observer group and control group were( 0. 79 ± 0. 13)g/cm2 and(0. 66 ± 0. 05)g/cm, the difference was statistically significant( t =10. 251,P ﹤0. 05 ). Conclusion The effect of locking plate fixation with anti-osteoporosis drug is better with shorter hospital stay,safe and reliable,and it is worthy of clinical application.

Objective To investigate the clinical effect of small incision for total hip arthroplasty on osteoporosis treatment of elder patients with fracture of the femoral neck.Methods Fifty-six elder patients with femoral neck methods were selected as our subjects,who were hospitalize from Jan.2011 to Dec.2013 in Xiahuayuan Meikuang Hospital,Zhangjiakou Company Limited.They were randomly divided into the observation group (26 cases) and control group (30 cases).All patients were treated with small incision total hip arthroplasty.The patients in the observation group were given the alendronate sodium.The curative effect,hospitalization time,bone mineral density were recorded.Results The long-term efficacy of the excellent and good rate of the observation group was 96.2％ (25/26),higher than that in control group(86.6％ (26/30)),and the difference was statistically significant(x2 =4.125,P ＜ 0.05).The length of hospitalized time in observation group was (26 ± 4) d,shorter than that in the control group (35 ± 3) d,and the difference was statistically significant(t =9.102,P ＜ 0.05).The bone density of patients in the observation group was (0.64 ± 0.03) g/cm2,higher than that in control((0.61 ± 0.05) g/cm2),and there was significant difference between two groups (t =8.461,P ＜ 0.05).Conclusion The effect of small incision total hip arthroplasty combined with anti osteoporosis drugs for the treatment of femoral neck fractures in the elderly is good and worthy of clinical usage.

Objective: To describe the distribution and drug resistance of pathogens at hematology department of Jiangsu Province from 2014 to 2015 to provide reference for empirical anti-infection treatment. Methods: Pathogens were from hematology department of 26 tertiary hospitals in Jiangsu Province from 2014 to 2015. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or agar dilution method. Collection of drug susceptibility results and corresponding patient data were analyzed. Results: The separated pathogens amounted to 4 306. Gram-negative bacteria accounted for 64.26%, while the proportions of gram-positive bacteria and funguses were 26.99% and 8.75% respectively. Common gram-negative bacteria were Escherichia coli (20.48%) , Klebsiella pneumonia (15.40%) , Pseudomonas aeruginosa (8.50%) , Acinetobacter baumannii (5.04%) and Stenotropho-monas maltophilia (3.41%) respectively. CRE amounted to 123 (6.68%) . Common gram-positive bacteria were Staphylococcus aureus (4.92%) , Staphylococcus hominis (4.88%) and Staphylococcus epidermidis (4.71%) respectively. Candida albicans were the main fungus which accounted for 5.43%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were 3.5%-6.1% and 5.0%-6.3% respectively. The rates of Pseudomonas aeruginosa resistant to tobramycin and amikacin were 3.2% and 3.3% respectively. The resistant rates of Acinetobacter baumannii towards tobramycin and cefoperazone/sulbactam were both 19.2%. The rates of Stenotrophomonas maltophilia resistant to minocycline and sulfamethoxazole were 3.5% and 9.3% respectively. The rates of Staphylococcus aureus, Enterococcus faecium and Enterococcus faecalis resistant wards vancomycin were 0, 6.4% and 1.4% respectively; also, the rates of them resistant to linezolid were 1.2%, 0 and 1.6% respectively; in addition, the rates of them resistant to teicoplanin were 2.8%, 14.3% and 8.0% respectively. Furthermore, MRSA accounted for 39.15% (83/212) . Conclusions Pathogens were mainly gram-negative bacteria. CRE accounted for 6.68%. The rates of Escherichia coli and Klebsiella pneumonia resistant to carbapenems were lower compared with other antibacterial agents. The rates of gram-positive bacteria resistant to vancomycin, linezolid and teicoplanin were still low. MRSA accounted for 39.15%.