Objective To study and observe the clinical efficacy of using non skid plate by posteromedial approach for fixing splitting or compression tibial plateau fracture.Methods Twenty eight cases of patients who were treated for fixing splitting or compression tibial plateau fracture from January 2014 to January 2016 in people's hospital of Xinyu were retrospectively reviewed.All patients were treated byposterior medial approach with non skid plate for fixation,all patients were followed up by postopera tive imaging and clinical follow-up to observe its clinical curative efficacy.Results Twenty-eight patients were followed up,the mean follow-up time was 12 months.All patients had no internal fixation loosening fracture,send,vascular and nerve damage and other adverse reactions.All the patients were healed within 4 to 7 months,the average healing time was 18.5 weeks.After healing,knee joint function was evaluated,18 cases were excellent,5 cases were good,the excellent and good rate was 82.1 ％.Conclusion The efficacy of using non skid plate by posteromedial approach for fixing splitting or compression tibial plateau fracture is good,it is worthy of clinical application.

Objective To compare the influence for intravenous dexmedetomidine and midazolam during combined spinal and epidural anesthesia (CSEA) on sedation,respiratory and circulatory.Methods Ninety patients with lower extremity fractures and internal fixation,were divided into dexmedetomidine group,midazolam group and control group by random digits table with 30 cases each.CSEA was performed at L3-4 interspace.After block reached T8 level,dexmedetomidine,midazolam and 0.9％ sodium chloride were given to the three groups.Ramsay score,mean arterial pressure (MAP),heart rate (HR),partial pressure of carbon dioxide in end expiratory gas (PErCO2),respiratory rate (RR) were recorded before anesthesia(T0),after CSEA (T1),and 10,15,30,45,60 min after giving drug (T2-T6),and intraoperative awareness was recorded.Results Ramsay score in dexmedetomidine group and midazolam group at T2-T6 were higher than those in the group T0,T1 and concurrent control group (P ＜ 0.05),MAP were lower than those in the group T0,T1 and concurrent control group (P ＜ 0.05).HR in dexmedetomidine group at T2-T6 were lower than those in concurrent midazolam group and control group (P ＜ 0.05).PETCO2 in midazolam group at T2-T6 were higher than those in concurrent dexmedetomidine group and control group (P ＜ 0.05),RR were lower than those in concurrent dexmedetomidine group and control group (P ＜ 0.05).The rate of intraoperative awareness in dexmedetomidine group and midazolam group was lower than that in control group [16.7％(5/30) and 13.3％(4/30) vs.93.3％(28/30),P＜0.05].Conclusions Dexmedetomidine and midazolam provide good sedation to reduce intraoperative awareness,slight inhibition of blood pressure.Dexmedetomidine can decrease HR,but it does not influence respiratory function.Midazolam restrains respiratory function.

Objective To evaluate the effects of parecoxib sodium for preemptive analgesia in patients undergoing cerebral angiography. Methods Sixty patients undergoing cerebral angiography were divided into two groups by random digits table with 30 cases in each : group P and group F. Patients in group P received parecoxib sodium 40 mg 30 min before operation, while group F received fentanyl 1 μ g/kg 2 min before operation. The changes of hemodynamics were observed before operation (To), immediately right internal carotid artery angiography during operation (T1), immediately right vertebral artery angiography (T2),immediately left internal carotid artery angiography(T3), immediately left vertebral artery angiography(T4), 10min after operation (T5). The mean arterial pressure (MAP), heart rate (HR), pulse oxygen saturation (SpO2)and visual analogue score (VAS) were recorded at different times during the whole operation. Results There were no significantly differences on MAP, HR and VAS between group P and group F (P ＞ 0.05 ). But the SpO2 at T1 ,T2,T3 in group F (0.94±0.03,0.95±0.02,0.95±0.02) were significantly lower than those in group P (0.98 ± 0.01,0.98 ± 0.02,0.98 ± 0.02 )(P＜0.05 ), and 2 cases SpO2 ＜ 0.90 at Ti. Conclusion Parecoxib sodium administered preemptively provides a nice analgesic effect in patients undergoing cerebral angiography, and is more safe than fentanyl.

OBJECTIVE: To study the status quo and future trend of digestive system drugs used in our hospital. METHO-DS: The digestive system drugs used in our hospital between 2001 and 2005 were analyzed retrospectively in respect to drug kinds, consumption sum, DDDs, daily costs etc. RESULTS: Drugs for peptic ulcer and hepatobiliary diseases took a big proportion and experienced a year- on- year increase. No significant change was noted for the top 10 drugs on the lists of DDDs and consumption sum before and after the medical insurance reform, but their order changed a little. The DDDs of most of the cheap and effective drugs increased after the medical insurance reform. CONCLUSION: The consumption of antiulcer drugs and drugs for hepatobiliary diseases in our hospital assume an increasing tendency.

Objective To explore the effect of different doses of tirofiban for PCI, myocardial injury and arterial flow conditions.Methods 70 patients undergoing PCI elevation acute myocardial infarction, were randomly and equally divided into the observation group and the control group.The control group of patients before PCI given haplotype character loading dose of tirofiban, the observation group were given a double load before PCI tirofiban.Recording and analyzing two groups of patients cTnI (cardiac troponin I), 90 minST section down percentage circumstances.Results The patients after 6h, 12h, 24hcTnI contents were (2.11 ±0.50,3.50 ±1.64,3.28 ±1.15) ng/mL was significantly lower than the control group (4.09 ± 1.13,9.48 ±2.61,5.79 ±1.26) ng/mL, and the difference was significant(P<0.05); the observation group were CTFC, 90 min fall within ST respectively was significantly better than the control group ( P<0.05 ) .Conclusion Preoperative use of double loading dose of tirofiban can effectively improve the blood flow after PCI,, and reduce the incidence of myocardial injury and postoperative cardiovascular events.

Objective To make an epidemiological investigation on TORCH infection in children in Pu′er city of Yunnan prov‐ince ,in order to provide references for the prevention and treatment of TORCH infection in children .Methods A total of 1 194 children treated at this hospital from January to December 2014 were selected and divided into five age groups .Serum TORCH spe‐cific IgM and IgG antibodies were detected by using enzyme‐linked immunosorbent assay(ELISA) and the positive rate of TORCH specific antibody and TORCH infection rate were comparatively analysed .Results The positive rate of TORCH specific IgM anti‐body was significantly lower than that of IgG .The range of positive rate of IgM was 0 .00% -3 .10% ,and that of IgG was 10 .13% -82 .24% .The total infection rate of TORCH was 96 .98% .There were no significant differences in the infection rate of single item of TORCH or the total TORCH infection rate among the five different age groups(P>0 .05) .The distribution of infec‐tion rate of single item of TORCH among the five age groups was statistically significantly different(P<0 .05) .There was no sig‐nificant difference in the infection rate of TORCH or the distribution of infection rate of single item of TORCH among different sea‐sons(P>0 .05) .Conclusion Children with TORCH infection in this area mainly are infected by CMV ,followed with RV and HSV infections ,while TOX infection is uncommon .There are no obvious differences in different seasons and children in different age groups .

Objective To analyze the results of children′s respiratory tract infection pathogens IgM antibody nine‐combined de‐tection in Pu′er and grasp the epidemiological characteristics of respiratory tract infection of local children for providing reference for clinical diagnosis and treatment .Methods 1 327 cases of children′s blood sample with respiratory tract infection were randomly sampled from in Pu′er People′s Hospital in 2014 .All the samples were tested with nine respiratory tract infection pathogens IgM antibody detection reagent kit(indirect immunofluorescence) ,and the test results were adopted for statistical analysis .Results There were 446 cases positive for IgM antibody in 1 327 cases of respiratory tract infection children ,the total positive rate was 33 .6% .The Positive rate of mycoplasma pneumonia(MP) was the highest ,for 23 .6% .The second was influenza B virus(INFB) , for 18 .5% .The eosinophilic lung legionella type 1(LP) ,adenovirus(ADV) ,respiratory syncytial virus(RSV) ,influenza A(INFA) and parainfluenza virus(HPIVs) were all much lower :respectively for 0 .4% ,1 .1% ,1 .0% ,1 .1% and 1 .0% .It was showed that no positive results were found in Q fever rickettsia(CB) and chlamydia pneumonia(CP) .There was significant difference of the positive rate among 9 kinds of pathogens(P<0 .05) .There was significant difference of the monthly positive rate among the main six patho‐gens(P<0 .05) .There was significant difference of the positive rate in the different age groups(P<0 .05) .Conclusion The respir‐atory tract infection pathogens of children in Pu′er are mainly mycoplasma pneumoniae and influenza B virus .The epidemiological distribution of the pathogens is related to the age and season ,the clinician should reasonably diagnose and treat according to the test results for children .

Objective To investigate the effect and clinical significance of HBV replication on the serum levels of IL-12 and IL-18 in patients with hepatitis B-related cirrhosis.Methods The levels of HBV-DNA and IL-12 and IL-18 in peripheral blood from 136 patients with different clinic types chronic hepatic diseases(102 patients with chronic hepatitis B,34 patients with hepatitis B-related cirrhosis ),95 HBV carriers and 20 healthy people (as control group) were respectively detected with ELISA and real time PCR.Results The levels of IL-12 and IL-18 in chronic hepatitis B and hepatitis B-related cirrhosis groups were significantly increased compared with control group(P0.05); and there was positive relationship between prevalence of HBV replication and IL-12,IL-18 levels in different chronic hepatic disease groups(r=0.74,P

Objective To investigate the value of surgical biopsy with guidance of indwelling wire through stereotactic puncture in the diagnosis of occult breast cancer (OBC) and the clinical usage. Method Surgical biopsy was performed on 22 patients with suspected nonpalpable breast lesions. ResultsSurgical biopsy, including localization and resection of the lesion, under the guidance of a guide wire was successful with single procedure for all 22 lesions. The accuracy of qualitative diagnosis was 100%. Pathological examination showed malignant in 9 lesions and benign in 13 lesions. ConclusionThe surgical biopsy with the guidance of indwelling wire through stereotactic puncture is valuable technigue for the diagnosis of occult breast lesions.

Extracorporeal membrane oxygenation(ECMO) is a kind of extra life support technique that can support cardiac and pulmonary function in a relatively long time.With the application of nitric oxide,pulmonary surfactant and high frequency ventilation,the use of ECMO in neonatal respiratory failure decreased.Although received these treatment,there are some newborn with respiratory failure still required ECMO at last.On this paper,the application of ECMO in neonatal respiratory failure from foreign medical institute was introduced,and compared with the domestic situation,in order to improve the application of ECMO in neonatal respiratory failure.