0 05 ) . But the results in the adolescent adult group undergone MED were better than the aged group (p0 05 ).Intravertebral complications had a significant effect on operative results (p

0 05); the infection rate of deep wound Ⅲ degree was the lowest in delayed wound closing group. Conclusions It is key to improve the quality of the initial diagnosis and treatment,its measures are effective early stage debridement, the use of antibiotic, reasonable wound closing ,drainage,fixation, primary bone graft,bone plantation at phase Ⅰ and rigid selection of amputation; interlocking medullary nailing and external fixation stand with limited internal fixation are effective methods for the fixation of open fracture of tibia in the initial diagnosis and treatment.

Objective To investigate the etiology of acute recurrent pancreatitis (ACP) and de-termine how to further enhance its level of treatment.Methods The clinical data of 33 patients with ACP treated in Ruijin Hospital from 2003 to 2007 were retrospectively analyzed.Results Of the 33 patients with an average age of 55 (22-86), 18 (55%) were male and 15 (45%) female.ACP occurred once in 26 patients, twice in 4 and 3 times in 3.The disease appeared whithin 1 year in 29 patients, 1-2 years in 2, 2-3 years in 1 and 3 years in 1 after being dischared from hospital.For its etiology, it was of biliary origin in 29 patients, hyperlipidemia in 1, pancreatic tumor in 1 and unknow reasons in 2.Twenty-four patients were treated with operation or endoscopy.Two patients died and the mortali-ty was 9.1%.Conclusion ACP is mainly due to biliary origin in China.Operative intervention at an appropriate opportunity can effectively reduce the recurrence of biliary-origin pancreatitis.