Objective To evaluate clinical effects of the treatment of tibial fractures through compression reduction and osteosynthesis with common plate. Methods From March 2001 to September 2003, 48 cases of tibial fractures were treated through compression reduction and osteosynthesis with common plate. Results All the cases were followed up for 6 to 24 weeks (averaging 14 weeks). The healing time was 12 to 16 weeks (averaging 5 weeks). No delayed union, non union, infection, or ineffective internal fixation occurred. Conclusion Compression reduction and osteosynthesis with common plate to treat tibial fractures is a kind of biomechanical fixation that facilitates fracture healing.

Aiming at the characteristics of biochemistry and the advantages of web-based courses and combining with teaching practice,a kind of web-based courses has been constructed which practices in the internet.The key of construction will be detailed from general design,page design and some design skills.

Aiming at the characteristics of biochemistry and the special advantage of flash and basing on teaching practice,we set up a set of biochemistry flash animation database,providing a series of immediate flashes and being applied to teaching practice of biochemistry,which shows the great potential of flash in improving biochemistry teaching quality.

Objective To evaluate the value of spiral CT volume reconstruetion(VR) technique in high complex anal fistula fistulography. Methods To analyze retrospectively internal openings and secondary tracts of 35 eases with high complex anal fistula verified by operation and follow-up above 3 months with VR,and compared with operation and outcome of follow-up. Results In 35 eases with high complex anal fistula, for detection of the presence of internal openings ,VR has a sensitivity of 72.7% ,a specificity of 100% ,a accuracy of 74.3% ,a positive predictive value of 100% ,and a negative predictive value of 18.1%. Secondary tracts have a sensitivity of 93.8% ,a specificity of 100.0% ,a accuracy of 94.6% ,a positive predictive value of 100.0% ,and a negative predictive value of 72.7%. Conclusion VR can demonstrate the 3D shape of fistula and is reliable in the diagnosis of internal openings and sec-ondary ducts, and is very valuable in the analysis of high complex anal fistula fistulography.

Objective Taking typical cases of Western medicine as an example,this paper explores the connection between Chinese and Western medicine on the understanding of tongue elephants.Methods After collecting the literature with tongue diagram attached to the clinical imaging column published in NEJM magazine,extracting the symptoms,signs and Western medicine disease information recorded in the literature,the tongue diagram was diagnosed from three aspects:tongue quality,tongue moss and sublingual meridians,and whether the symptoms and signs of tongue correspond to a certain diagnosis result,and the results were analyzed.Results A total of 48 articles were included,including 6 literature on abnormal tongue dynamics,which could correspond to abnormal tongue morphology in traditional Chinese medicine.Thirty-four cases of abnormal tongue shape were found.Among them,12 cases could be diagnosed with corresponding TCM tongue diagnosis,including 7 cases of abnormal tongue shape and 5 cases of abnormal coating.The remaining 22 cases were secondary changes in tongue structure.There were 8 articles on abnormal tongue color,including 1 abnormal tongue color,1 abnormal sublingual chord,and 6 abnormal lichen color.Conclusion Starting from the form and function,explore the connection between Chinese medicine and Western medicine in their understanding of tongue diagnosis,and promote the objectification and standardization of Chinese medicine tongue diagnosis.

Objective:To discuss the feasibility and safety of modified side overlap with fundoplication by Yamashita (mSOFY) in laparoscopic proximal gastrectomy.Methods:Using the method of descriptive case series study, the clinical data of 9 patients with upper gastric cancer who successfully performed mSOFY anastomosis from March 2022 to October 2022 in the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University were retrospectively analyzed.The reconstruction steps of mSOFY anastomosis are as follows: (1) Make a small incision on the right side of the esophageal stump and in front of the anterior wall of the gastric stump; (2) The 45mm linear cutting stapler is placed into the preset anastomosis of the esophagus and the remnant stomach, and the esophagus is rotated 90° counterclockwise along the axis, so that the right wall of the esophagus is anastomosed with the remnant stomach, and the stomach wall is sutured to the left side of the esophagus; (3) The common opening of esophagus and remnant stomach was sutured with inverted suture; (4)Suture the left and lower sides of the esophagus with the remnant stomach to make the esophagus flat against the stomach wall; (5) Open the sutured common opening: due to the pressure of the false dome, the posterior wall of the lower esophageal segment was compressed into a valve-like structure. We mainly observing the postoperative reflux and nutritional improvement of the patients, and recording the intraoperative situation and postoperative complications.Results:Nine patients with upper gastric cancer who completed laparoscopic proximal gastrectomy (mSOFY anastomosis) did not have conversion to laparotomy or intraoperative / postoperative complications. The operation time was (169.4±10.4) minutes, the anastomotic reconstruction time was (51.7±7.1) minutes, the intraoperative bleeding volume was (98.9±43.4) ml, and the number of lymph nodes dissected was (27.2±6.7). The patient recovered well after operation, without any complaints related to reflux esophagitis. Postoperative gastrointestinal radiography showed that the anastomosis was smooth, without stenosis and leakage. The serum albumin [(41.6±3.4) L vs. (39.9±2.6) L], prealbumin [(211.3±38.6) mg/L vs. (205.3±36.0) mg/L], and hemoglobin levels [(126.7±13.2) g/L vs. (121.0±9.7) g/L] of patients before and one month after surgery have no statistically significant differences (all P>0.05). Conclusion:mSOFY anastomosis can be used as one of the safe and feasible reconstruction methods in laparoscopic proximal gastrectomy.

Objective:To discuss the feasibility and safety of modified side overlap with fundoplication by Yamashita (mSOFY) in laparoscopic proximal gastrectomy.Methods:Using the method of descriptive case series study, the clinical data of 9 patients with upper gastric cancer who successfully performed mSOFY anastomosis from March 2022 to October 2022 in the Affiliated Huaian No.1 People's Hospital of Nanjing Medical University were retrospectively analyzed.The reconstruction steps of mSOFY anastomosis are as follows: (1) Make a small incision on the right side of the esophageal stump and in front of the anterior wall of the gastric stump; (2) The 45mm linear cutting stapler is placed into the preset anastomosis of the esophagus and the remnant stomach, and the esophagus is rotated 90° counterclockwise along the axis, so that the right wall of the esophagus is anastomosed with the remnant stomach, and the stomach wall is sutured to the left side of the esophagus; (3) The common opening of esophagus and remnant stomach was sutured with inverted suture; (4)Suture the left and lower sides of the esophagus with the remnant stomach to make the esophagus flat against the stomach wall; (5) Open the sutured common opening: due to the pressure of the false dome, the posterior wall of the lower esophageal segment was compressed into a valve-like structure. We mainly observing the postoperative reflux and nutritional improvement of the patients, and recording the intraoperative situation and postoperative complications.Results:Nine patients with upper gastric cancer who completed laparoscopic proximal gastrectomy (mSOFY anastomosis) did not have conversion to laparotomy or intraoperative / postoperative complications. The operation time was (169.4±10.4) minutes, the anastomotic reconstruction time was (51.7±7.1) minutes, the intraoperative bleeding volume was (98.9±43.4) ml, and the number of lymph nodes dissected was (27.2±6.7). The patient recovered well after operation, without any complaints related to reflux esophagitis. Postoperative gastrointestinal radiography showed that the anastomosis was smooth, without stenosis and leakage. The serum albumin [(41.6±3.4) L vs. (39.9±2.6) L], prealbumin [(211.3±38.6) mg/L vs. (205.3±36.0) mg/L], and hemoglobin levels [(126.7±13.2) g/L vs. (121.0±9.7) g/L] of patients before and one month after surgery have no statistically significant differences (all P>0.05). Conclusion:mSOFY anastomosis can be used as one of the safe and feasible reconstruction methods in laparoscopic proximal gastrectomy.

Objective: To investigate the value of clinical data and qualitative and quantitative computed tomography (CT) in predicting the pathological grade of thymoma． Methods: The clinical data and CT images of 81 patients with confirmed pathological diagnoses of thymoma were retrospectively analyzed．The patients were divided into low-risk and high-risk groups according to the pathological results，and the clinical features and qualitative and quantitative CT findings were compared between the groups．The efficacy of different parameters in predicting the pathological thymoma grade was evaluated by logistic univariate and multivariate regression analyses and receiver operating characteristic (ROC) curves. Results: Sixty-two tumors were classified as low-risk thymoma and 19 as high-risk thymoma. The efficacies of both the maximum CT values on enhancement and maximum degree of enhancement for risk prediction were statistically significant (P＜0. 001)．Logistic regression analysis showed that both the maximum CT values on enhancement (OR = 0. 88，95% CI : 0. 83 － 0．94) and maximum degree of enhancement (OR = 0. 92，95% CI :0. 88－0. 97) were independent predictors of thymoma risk (P＜0. 001)．The area under the ROC curve (AUC) of the maximum CT values on enhancement was 0. 884，with a sensitivity of 68. 4% and a specificity of 96. 8% ; the AUC of the maximum degree of enhancement was 0. 833，with a sensitivity of 89. 5% and a specificity of 72. 6% . Conclusion Quantitative parameters based on enhanced CT are helpful for the preoperative prediction of thymoma risk stratification．The predictive efficacy of the maximum CT values on enhancement is superior to that of the maximum degree of enhancement.