Objective To explore the therapeutic efficacy for fractures around the knee with concurrent vascular and nerve injury.Methods The clinical data of 75 patients with fractures around the knee with concurrent vascular and nerve injury treated were retrospectively analyzed.And fracture reduction,vascular repair and nerve repair were given depending on degree of injure.Therapeutic efficacy of the treatments was recorded.Results 5 cases were amputation,while the others were alive,the rate of efficacy was 93.06％.27 of the 31 cases of contusion nerve were returned to normal,4 were returned to part of the sensory-motor,11 of 13 cases of completely torn nerve were recovering well,and 2 of which were 2 degree,and the rate of efficacy was 86.36％.Conclusion The appropriate measures and early treatment should be given,by which prognosis of limb could be improved comspicuously,and the order of vascular repair and fractures fixation is influential on surgery success.

After the concept of risk of literature acquisition was described, its universal, objective, losing, controllable and social featureswere pointed out , followed by an analysis of the factors and related conditions for its occurrence , its consequences and possible losses, with measures proposed for its control.

The medical teaching assistant terrace has been established and finished in the digital libraries.It has increased library function,satisfied medical teaching innovating demand and advanced library value and position.It has also provided the chance and established the direction of the development for library and its workers.

It is required by objective reality to discuss the teaching conception and mode of evidence-based medicine,based on its nature and from the fundamental differences between it and traditional medicine.

Objective To understand the prevalence of erectile dysfunction (ED) in elderly male and to provide the basis for clinical diagnosis and treatment of ED. Methods The questionnaire about sexual history was used, and related past history, medication and life-style were reviewed. Results Total prevalence of ED was 89.7% in the 272 elderly male persons. The prevalence of 60-years group, 70-years group and 80-88 years group was 75.9%, 78.6% and 100%, respectively. Among ED patients, 95.1% of them suffered from hypertension. Conclusions Prevalence of ED in elderly male persons is associated with the ageing and the hypertension.

Aiming at the litigation to medical treatment dispute since new rule, there are different reply words and actions existing in medical service providers,according to the request of the new rule, the author analyzed doctor-patient relationship and medical treatment dispute,medical service and reform,'proof'consciousness and work circumstance of doctors,bring upped the request that the medical treatment organization and its members should reply to the new rule from thought consciousness,doctor-patient relationship,rules in medical service practice, proof system,etc.

According to the main problems existing in the rural patriotic hygiene work at present, this article analyses the causes of these problems from both the subjective and objective respects. According to the goal of building a well-off society in an all-round way and safeguarding the health interests of 900 million farmers, this article tries to discuss the guideline and principle of ethics on the rural patriotic hygiene work and put forward the code of ethics to do a good job in the rural patriotic hygiene work.

Objective To observe the clinical effect of mifepristone combined with intramuscular injection of methotrexate in the treatment of cesarean scar pregnancy.Methods Fifty-six patients with uterine scar pregnancy after cesarean section were divided into observation group and control group by random number method.The control group was intramuscularly injected methotrexate,the observation group was given methotrexate combined with mifepristone therapy.The therapeutic effect,blood β human chorionic gonadotropin(β-HCG) decreased to normal time,vaginal bleeding time,mass size were observed.Results After treatment,the serum β-HCG decreased to normal time[(15.96±3.71)d] and vaginal bleeding time[(5.12±2.08)d] of the observation group were significantly shorter than those of the control group [(25.42±4.02)d,(7.39±3.37)d],the mass size of the observation group [(1.88±0.15)cm] was also significantly smaller than (2.14±0.33) cm of the control group,and there were significant differences between the two groups(t=4.3142,3.0331,3.7954,all P＜0.05).Conclusion Mifepristone combined with intramuscular injection of methotrexate has significant effect on uterine scar pregnancy after cesarean section.

Objective To observe the clinical manifestation and ophthalmoscopic image characteristics of uveal metastatic carcinoma.Methods Thirty-six uveal metastatic carcinoma patients (43 eyes) were enrolled in this study.The patients included 21 males and 15 females.The patients' ages ranged from 28 to 71 years,with a mean age of (47.3 ±10.2) years.Seven patients had bilateral carcinoma and 29 patients had unilateral carcinoma.There were 30 patients with lung cancer,three patients with breast cancer,one patient with gastric cancer and two patients without primary tumors.There were 20 patients with known primary cancer,16 patients visited the Department of Ophthalmology first.All the patients were examined documenting visual acuity,intraocular pressure,slit-lamp microscopy and mydriatic fundus examination.Meanwhile,22 patients (26 eyes) were examined using B-type ultrasound and/or color Doppler flow imaging(CDFI).Twelve patients (12 eyes) were examined using fundus fluorescein angiography (FFA) and/or indocyanine green angiography (ICGA).Seventeen patients (22 eyes) were examined using MRI and/or CT.The clinical manifestation and ophthalmoscopic image characteristics of uveal metastatic carcinoma patients were observed.Results Among 43 eyes,four lesions were in the iris,three lesions in the ciliary body and 32 lesions were in the choroid.Fundus examination showed an isolated mass in 26 eyes and more than two masses in nine eyes.Metastatic tumors of the iris and ciliary body often showed irregular cauliflower-like mass with gray-white or meat-red color and abundant vessels.The choroidal metastasis usually demonstrated flat rounded or irregular intraocular masses with gray-yellow or gray-white color in the posterior pole.B-type ultrasound showed ill-defined,flat,and irregular-shaped masses with uneven internal reflectivity.CDFI showed rich blood flow within the tumor.FFA and (or)ICGA showed pinpoint and mottled leaks against hyperfluorescence background.MRI revealed low or middle signal using T1 WI and low signal intensity using T2WI.Conclusions The uveal metastatic carcinoma usually occurs in one eye with an isolated mass.Most of them show a flat gray-yellow mass in posterior choroids and have the primary cancer sites of the lung.FFA and/or ICGA show pinpoint and mottled leaks against hyperfluorescence background.B-type ultrasound and (or) CDFI show ill-defined,flat,and irregular-shaped mass with rich blood flow within the tumor.MRI reveals low signal intensity on T2 WI.

Objective To establish the measuring methods and relevant influencing factors of liver zone speed index (ZSI) by sound velocity tissue quantification (SVQ) technology in healthy subjects.Methods Liver ZSI were obtained in 49 healthy volunteers using SVQ technique with Zonare Z.one Ultra system.In the first 15 subjects,ZSI were acquired at four positions (superficial and deep parts of right lobe,superficial and deep parts of left lobe).Then the achievement rate in different position of liver was calculated to select the suitable measuring position.The reproducibility was analyzed with intra-group correlation coefficient(ICC).The last 34 healthy subjects received ZSI measurements in the appropriate position only.The reference value of ZSI was calculated using x-± 1.96 s.Results It was stable to measure values of ZSI with SVQ technique.The achievement rate was higher in right lobe with being 1 cm below the liver capsule for the optimal measuring point.There was no significant difference of ZSI value between male and female groups.There was no significant correlation between age and values of ZSI while a significant negative correlation was found between body mass index (BMI) and values of ZSI (r =-0.63,P =0.000).The reference value of body mass index between 18.5-23.9 kg/m2 was 5.67-36.29 m/s.Conclusions ZSI values of liver measured with SVQ technique shows a good stability and may be a new promising method for assessment of liver elasticity quantitatively.