BACKGROUND:Closed reduction and interlocking intramedullary nailing can protect blood supply of fractured bone,decrease infection and promote bone healing.which is becoming the first choice for treating femoral shaft fracture However,it is difficult to conduct in closed reduction and keep stabilization of fractured bone.OBJECTIVE:To explore the curative effect of closed reduction and interlocking intramedullary nailing in treating femoral shaft fracture with assist of rubber tourniquet 360°elastic fixation METHODS:From May 2008 to November 2009,18 patients(14 males,4 females;aged 18-65 years)with closed femoral shaft fracture were treated at the Dongguan Hospital of Traditional Chinese Medicine.Body skin was protected by cloth,elastic rubber tourniquet was doubled and 360°wrapped around the fractured bone with the length of 10 cm from up and down.Supracondylar femur was reamed by Kernig-needle;fractured bone was dealt with countertraction and horizontal rotation.Another assistant compressed the fractured bone according to the displacement of fracture,which contributes to bone fracture reduetion and interlocking intramedullary nailing.RESULTS AND CONCLUSION:All 18 patients were followed up postoperatively,no case was found with skim necrosis and damage of nerve and blood vessel.16 cases were bone union with excellent 15 cases,fine 1 case;2 cases were still being followed up.Callus was firstly found 1 month after operation and was obviously found in 3e months postoperatively The result suggested that the treatment of closed reduction and interlocking intramedullary nailing with assist of rubber tourniquet360°elastic fixation is a simple and applicable approach.which reduces the interruption of blood supply for fractured bone and closed reduction gets good result,which reduces the chance of open reduction.

Objective To evaluate the outcome of patients with low ejection fraction undergoing coronary artery bypass grafting.Methods One hundred and twenty-eight consecutive patients with left ventricular ejection fraction (LVEF) ≤35％,who underwent Off-pump caronary bypass surgery or Cardiopulmonary coronary artery bypass between December 2000 and Novomber 2010 were studied.The outcome of early complication,mortality,LVEF were analyzed.Results LVEF and LVEDD were significantly increased in early postoperation (P ＜ 0.05 ).Use of Intra-aotric balloon counterpulsation(IABP) can decrease early mortality,and postopertive respiratory tract infections,renal insufficiency were found to be the main complications.Conclusions Preoperative low ejection fraction has no relationship with postoperative early mortality.using medicine to adjust heart function,strcity control blood pressure,blood glucose,heart rate preoperation,positive use of IABP postoperativon are key point to decrease early mortality.

Objective To investigate preoperative myocardial enzymes and realative influencing factors in Stanford B type aortic dissection.Methods From Jan.2004 to Sep.2013,151 consecutive patients with Stanford type B aortic dissection were admitted to hospital,aged from 31 to 76 average:(51.51 ± 10.90)year sold.Ninty-five healthy people with similar age and sex were taken as the control group.Fasting venous blood collected more than 12h was collected,myocardial enzymes indexes such as CK,CKMB,LDH,HBDH were measured by Roche modular automatic biochemical analysis system.Primary entry tear and extent of aortic dissection was measured by Toshiba Aquilion ONE 320 slice CT.Degree of aortic valve insufficiency was measured by Philips Sonos 5500 Color Doppler ultrasonic diagnostic apparatus.Results Compared with control group,the level of myocardial enzymes (LDH,HBDH) of aortic dissection group increased significantly(P ＜ 0.01).part myocardial enzymes indexes(CK,LDH,HBDH) of acute stage group existed difference(P ＜ 0.05).Myocardial enzymes indexes only CK existed difference between acute stage group and subacute stage group and chronic stage group(F =18.72,P =0.000),no difference between subacute stage group and chronic stage group.LDH,HBDH of each sub group of aortic dissection group were higher than that of control group,P ＜ 0.01.Trough correlation analysis,CK negatively correlated with disease course of aortic dissection and patients sex [(r =-0.446 ; P =0.000) ; (r =-0.303 ; P =0.000)],CKMB negatively correlated patients sex [(r=-0.203;P=0.020)],LDH negatively correlated with patients sex [(r =-0.171 ;P =0.049)],positively with left ventricular end-diastolic diameter and left ventricular end-systolic diameter [(r =0.202 ; P =0.022) ; (r =0.271 ; P =0.002)].HBDH positively correlated with left ventricular enddiastolic diameter and left ventricular end-systolic diameter [(r =0.385 ;P =0.002) ; (r =0.515 ; P =0.000)],negatively with degree of aortic insufficiency [(r =-0.528 ;P =0.006)].Conclusions Myocardial enzymes rise in preoperative Stanford B aortic dissection,more representing skeletal muscle injury.Be affected by stage of aortic dissection,lower limb skeletal muscle injury aggravates more seriously in acute stage group persists entering the sub acute stage.

Traditional Chinese medicine dispensing granules（TCMDGs）is the new type of decoction pieces with the development of modernization of TCM， which has received mixed opinions since its practical application. In 2021， the national departments issued Announcement on Ending the Pilot Work of TCMDGs， marking the end of the 28-year pilot work of TCMDGs， and eligible TCM enterprises can produce TCMDGs after filing. However， this does not mean that the preparation process， quality standard and efficacy research of TCMDGs have been developed and matured， on the contrary， there are still some problems that need to be solved and gradually improved. For example， in the production process， there are problems such as unclear， unified and non-standardized preparation parameters. In terms of quality control， there are some problems such as lack of producing area regulation， variety selection and processing specification. In terms of consistency evaluation with traditional decoction， there are problems such as unclear relationship between the chemical constituents and pharmacological effects of the two. Therefore， in view of some prominent problems of TCMDGs at present， this paper takes the published literature as the main data source and combines the specific requirements of the code or technical standards such as the 2020 edition of Chinese Pharmacopoeia， Publicity of the Unified Standard on the Varieties of TCMDGs， Quality Control and Standard Formulation Technical Requirements of TCMDGs. The production process of TCMDGs， the origin and variety of raw materials， the processing of decoction pieces， the quality control standard and the consistency evaluation of formula granules and traditional decoction were sorted out and visualized by literature mining， data analysis and list comparison. Based on the analysis results， the following suggestions were made. In terms of preparation process， the completeness and standardization of process parameters should be strengthened. In terms of quality evaluation， attention should be paid to the relationship between the authenticity， variety， processing and quality of medicinal materials. In the consistency evaluation of formula granules and traditional decoction， the deep difference and mechanism between TCMDGs and traditional decoction were discussed by combining structural Chinese medicine， quality marker（Q-Marker） theory and physicochemical characterization， so as to provide reference for the application and development of TCMDGs.