Objective To evaluate the clinical application of nerve excitability test and stapedial reflex on the prognosis of facial nerve paralysis. Methods The threshold of excitability of the branches of facial nerves in both sides and stapedial reflex were tested in 50 patients.Results 34 patients out of 42 with differences of nerve excited threshold less than 3.5 mA showed complete recovery (81%),while only 2 patients out of 8 with the differences of nerve excited threshokd more than 3.5 mA showed recovery (25%), 32 patients out of 36 with positive response of stapedial reflex showed recovery (88.9%), but only 3 patients out of 14 recovered (21.4%) in non-response group.Conclusion The difference of nerve excited threshold of both sides less than 3.5 mA and positive response of stapedial refles showed a better prognosis, suggesting no severe injury to facial nerve and both nerve excitability test and stapedial reflex were useful chinical parameters to predict the prognosis of facial paralysis.

Objective To evaluate the value of diffusion-weighted imaging (DWI)in diagnosing the acute centrum ovale infarction, and also to investigate the pathogenesis of the infarction. Methods All 58 patients underwent conventional MRI and DWI scanning after symptoms’ onset. DWI findings were compared to the findings of T_1WI and T_2WI. Results The sensitivity and specificity in diagnosing the ischemia stroke were 96.4% and 98.8% within 7 days after onset. Of all the cases, 62.1% were associated with the cerebral large-vessel disease and emboligenic heart disease. Only 36.2% had a classic lacunar syndrome but 69.0% had more frequently an abrupt onset of symptoms. Conclusion DWI is of high accuracy for diagnosing centrum ovale infarction and detecting early infarction lesions which are difficult to be displayed in conventional MRI, and very helpful in differentiating the acute from non-acute lesions; symptomatic centrum ovale infarction is suggested to be associated with large-vessel and heart disease which should be distinguished from the lacunar infarcts.

Objective:To investigate the effects of a novel retrograde tibial nail (RTN) in the treatment of distal tibial fractures.Methods:A retrospective study was conducted in the 11 patients with distal tibial fracture who had been admitted to Department of Traumatic Orthopedics, The Second Affiliated Hospital, Hengyang Medical School from July 2020 to July 2021. There were 5 male and 6 females, aged from 18 to 70 years (average 54.7 years). By the AO/OTA classification, there were 7 extra-articular distal fractures (3 cases of type 43-A1, 3 cases of type 43-A2 and one type 43-A3) and 4 intra-articular fractures (2 cases of type 43-C1 and 2 cases of type 43-C2); by the Gustilo classification, there were 7 closed fractures and 4 open fractures (2 cases of type I and 2 cases of type Ⅱ). All fractures were fixated with a novel RTN. Deformities like distal tibial varus and valgus as well as fracture-related complications were observed after operation while the curative effects evaluated by the ankle-hindfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS).Results:This cohort was followed up for an average of 7.4 months (from 5 to 12 months). All patients obtained clinical union and recovered daily life and work. Radiographic evaluation showed no distal tibial varus or valgus. There were no such complications as postoperative infection, exposure of bone and internal fixation, compartment syndrome, or neurovascular lesion. According to the ankle-hindfoot score of AOFAS, 7 cases were excellent and 4 cases good.Conclusion:This novel retrograde tibial nail may result in good efficacy in the treatment of distal tibial fracture, but its advantages still need further verification.