Objective To investigate the effects of different operation methods for the treatment of distal tibial pilon fractures.Methods 40 cases of distal tibial pilon fractures were randomly divided into study group and control group,each of 20 cases.The research group used percutaneous insertion of the distal tibia locking plate internal fixation,the control group used the traditional open reduction and anatomical locking plate fixation.The average healing time,the incidence of complications and high rate of fracture healing were compared between the two group.Results The average healing time of the fracture study group(3.0±0.2)months was significantly shorter than that in the control group(4.0±0.3)months.Complication rate in the study group 5.0％ was significantly lower than that in the control group 35.0％.Fracture healing rate of study group 95.0％ was significantly higher than that of control group 65.0％.There was significant difference(P＜0.05).Conclusion The insertion of percutaneous locking plate fixation in the treatment of distal tibia has less trauma,simple operation,ankle joint function recovery,and the complication rate is low.

Objective To observe the efficacy and safety of venlafaxine on cognitive function in patients with post stroke depres-sion(PSD) .Methods 72 patients of cognitive dysfunction with PSD were selected and randomly divided into observation group and control group with 36 cases in each .The control group was treated with therapy for acute stroke .The observation group was treated with venlafaxine based on the treatment of control group .After 12 weeks of treatment ,the mini mental state examination(MMSE) , the Montreal cognitive assessment scale(MoCA) and activities of daily living scale(ADL) were used to evaluated the efficacy of the two groups before ,fourth weeks after and twelfth weeks after the treatment .The scores of the two groups were compared .The oc-currence of adverse reaction of the observation group was recorded .Results After 4 weeks treatment of the observation group ,the MoCA was (18 .52 ± 4 .37) .MMSE score was (20 .61 ± 4 .85) ,which were significantly higher than before treatment .And the ADL score was (35 .27 ± 4 .75) ,significantly lower than before treatment(all P<0 .05) .After 12 weeks of treatment ,the MoCA score of observation group was (20 .14 ± 5 .26) .MMSE score was (22 .46 ± 4 .59) .Which were all significantly higher than those of control group .While the ADL score was (29 .85 ± 5 .07) ,significantly lower than the control group(all P<0 .05) .The observation group with 2 cases had mild gastrointestinal discomfort ,2 cases with dizziness .Conclusion Venlafaxine can improve cognitive function in patients with post stroke depression .It can significantly improve patients′self-care ability and is safe .It can be further applied in the clinic .

Objective To explore the related factors of affecting the surgical treatment for aged patients with hip fracture.Methods The data of 139 patients who were over the age of 65 and underwent hip fracture surgery from March 2011 to August 2013 in the People’ s Hospital of Huidong County which affiliated to Guangdong Medical College and the First Affiliated Hospital of Nanchang University were se-lected.According to the Harris hip score at 6 postoperative months,all patients were divided into excellent group and poor group.And the risk factors of hip fracture surgery were explored by univariate analysis and logistic regression analysis.Results Univariate analysis showed that the age, fracture site, fracture type, injury to the operation time, ASA score, ADL score, surgical approach were the single risk factor of af-fecting the recovery of hip function in patients at 6 postoperative months.The age (OR=2.048),fracture type (OR=3.096),fracture type (OR=4.028), injury to the operation time (OR=5.174),preoperative ADL score (OR=3.560) and surgical approach(OR=3.928) were the multiple risk factors.Conclusion The functional recovery of elderly patients with hip fracture after surgery affected by multiple fac-tors,the preoperative prevention should be performed according to the actual situation of patients.

Objective To explore the clinical efficacy of Wenshen Juanbi Deco ction combined with warm acupuncture in the treatment of cold and dampness lumbar disc herniation. Methods Retrospective analysis of our hospital in April 2015 to February 2017 treatment of 60 cases of cold and humid lumbar disc herniation in patients with clinical data, according to different treatment methods were divided into control group and the study group,with 30 cases in each group.The control group underwent routine single Pelvic traction treatment, the study group underwent Wenshen Juanbi decoction combined with warm acupuncture treatment, The symptom improvement after treatment in two groups was compared. Results The total effective rate was 86.67% (26/30) in the study group and 58.06% (18/30) in the control group. The difference between the two groups was statistically significant (P<0.05). Compared with before treatment, the index of lower and lower extremity radiating pain, straight leg raising test, lower limb skin sensation, tendon reflex, spinous process tenderness and limited waist activity after treatment in the two groups were significantly improved (P<0.05). And the improvement effect of the study group was better than that of the control group (P<0.05). Conclusion Wenshen Juanbi Decoction combined with warm acupuncture is effective in the treatment of cold and dampness lumbar disc herniation, which can effectively improve the clinical curative effect and improve the clinical symptoms of patients with high clinical application and popularization value.

BACKGROUND:Three-dimensional finite element has been widely used in the oral cavity field, but little is reported on the three-dimensional finite element reconstruction of the mandibular body using titanium plate. OBJECTIVE:To study the biomechanical characteristics of reconstructing the mandibular body using titanium plate. METHODS:We established a three-dimensional finite element model of mandibular body defect undergoing reconstruction using bicortical titanium screws and titanium plate. Under the simulated normal occlusion state, a 200 N vertical load was added to the central fossa of the occlusal surface of the right mandible first molar. Then, stress distribution and maximum displacement of the mandible, titanium screw, and titanium plate were analyzed. RESULTS AND CONCLUSION:Under the simulated normal occlusion state, mandible stress was concentrated in the mandibular body and mandibular branch, especial y in the anterior and posterior edges of the mandibular branch and the lower edge of the mandible. The stress in the posterior edge of the mandible was lower than that in the anterior edge of the mandible, and moreover, the contact site between the titanium plate and the mandible also presented a concentration of stress. The maximum stress of the bicortical titanium screws appeared near the screw cap, and the stress was also concentrated at the contact site between the titanium screw and the titanium plate. The maximum stress of the titanium screw at the ascending branch of the mandible was higher than that of the titanium screw at the anterior end of the defect. For the titanium plate, the stress was mainly concentrated at the fixed site of the titanium screws;the peak stress of the anterior and posterior edges of the titanium plate was found at the contact site between the anterior end of mandibular defect and the titanium stress as wel as between the ascending branch of the mandible and the titanium screw. After mandibular body reconstruction using the titanium plate, a displacement was likely to occur at the contact site between the anterior end of mandibular defect and the titanium plate. In conclusion, these findings indicate that mandibular body reconstruction using bicortical titanium screws and titanium plate is relatively stable, but the titanium plate fixed at the anterior part of the mandibular angle is prone to breakage.

Objective: To analyze the etiology and epidemiological characteristics of influenza in Wenzhou from 2009 to 2014, so as to provide the scientific basis for control and prevention of influenza. Methods: Throat swab specimens of influenza like illness (ILI) were collected from national influenza surveillance sentinel hospitals for nucleic acid detection with real-time PCR and virus isolation, culture and sequencing, and the results were analyzed with statistical methods. Results: During the 8 years, a total of 10 577 089 cases from outpatient and emergency department were monitored in sentinel hospitals. There were 337 896 ILI cases with an average ILI treatment rate of 3.19%. A total of 4 046 ILI samples were detected in children, 511 were positive for influenza, the positive rate was 12.63%. Among the detected influenza types, type B had the highest proportion, followed by H3N2. Among the 6 age groups, the number of flu patients was the highest in 0-3 years old group, the positive rate in 10-12 years old group was the highest (35.03%). There were 28 and 45 amino acid sequence mutations of HA fragment in influenza A and B, respectively, which included multiple mutation of 391 and 145 amino acids. The phylogenetic analysis showed that the strains of type B were different in different years, and Yamagata evolved into Y1 and Y2 two branches. Conclusions The prevalence peaks of influenza in children occurred in winter and spring in Wenzhou city, accompanied by small peaks in summer. Three subtypes of serotypes B, H3N2 and A(H1N1) dominated alternatively in Wenzhou during the 8 years. We should focus on strengthening the prevention and control of influenza in preschool children and primary and secondary school students.