BACKGROUND:Healing time and plaster used in fixed position and fixed time are different between distal radius fractures and scaphoid fracture. When both fractures occur simultaneously, you cannot choose a fixed position and determine a fixed time. One-stage internal fixation for the distal radial fractures and scaphoid fractures simultaneously can obtain a good function. OBJECTIVE:To retrospectively analyze the effects of titanium locking compression plate and Herbert screw fixation for fresh unstable distal radial fractures with scaphoid fracture. METHODS:A total of 12 patients with fresh unstable distal radial fractures combined with scaphoid fracture were treated in the Shanxi Dayi Hospital from November 2011 to June 2014. Al cases received open reduction and locking compression plate fixation of the distal radius, open reduction of scaphoid fracture or percutaneous Herbert screw fixation. Fracture healing was observed during folow-up. At 6 months after treatment, wrist joint function was evaluated with modified McBride score. Range of motion of palmar flexion, dorsiflexion, ulnar deviation, radial deviation, pronation and supination and grip strength were measured. The distal radial shortening (difference in height of styloid process of radius and ulna), and angles of ulnar deviation and palmar tilt were measured with X-ray films. The data of healthy side and affected side were compared. RESULTS AND CONCLUSION:(1) 12 cases were folowed up for 6-24 months. (2) The distal radius and scaphoid fractures healed. The healing time of distal radius was 6-12 weeks, with an average of seven weeks. Healing time of scaphoid fracture was 3-6 months, with an average of 4.2 months. (3) Wrist score was evaluated using modified McBride scoring criteria at 6 months after treatment. There were excelent in 5 cases, good in 6 cases, and average in 1 case, with the excelent and good rate of 92%. (4) No significant difference in range of motion of palmar flexion, dorsiflexion, ulnar deviation, radial deviation, pronation and supination and grip strength, angles of ulnar deviation and palmar tilt, difference in height of styloid process of radius and ulna and modified McBride score was detected between healthy side and affected side (P > 0.05). (5) The median nerve injury in two patients was recovered within 6 months after postoperative exploration decompression. No complications appeared, such as infection, dorsal muscle tendon irritation symptoms, carpal tunnel syndrome, and internal fixation failure. (6) These findings confirm that fresh unstable distal radial fractures with scaphoid fractures can be treated with open reduction of the distal radius and locking plate fixation, open reduction of scaphoid bone or percutaneous Herbert screw fixation, with reliable fixation, high fracture healing rate, and good wrist function recovery rate; the repair effect is satisfactory.

300mg/d)were randomly divided into two groups:①Val group consisted of 20 cases(8M/12F),treated with Val 80~160mg/day.②Ben group 20 cases(9M/11F),treated with Ben 10~30mg/d.A goal of blood pressure(BP)control was 130/80mmHg or less in the two groups.Treatment period lasted for 8 weeks.The levels of UAE were measured by radioimmunoassay before and after treatment.We also measured Bp,fasting blood glucose,glycosylated hemoglobulin.Results After treatment of 8 weeks,Bp values in the two groups declined significantly compared with the pretreatment levels(P0.05).The levels of UAE in the two groups decreased significantly in comparison with pretreatment(P0.05).Val group seems to have lower adverse drug reaction rate.Conclusions The results indicate that Val has similar effects on reducing UAE in DN compared with Ben.And Val has fewer side effects.

[Objective]To investigate the metaphase result of extensive fusion in treatment of spondylolisthesis combined with intervertebral disc degeneration of adjacent joints.[Methods]Seventy-nine cases of lumbar spondylolisthesis combined with intervertebral disc degeneration of adjacent joints were treated with extensive fusion and internal fixation from September 2002 to September 2007.JOA and VAS scores were assessed and compared pre-and post-operatively.X-ray and CT were performed to observe the stabilization of fusion joints,and satisfaction rate from patients was investigated.[Results]All patients were followed up for 2 to 6.5 years(mean,4.6 years).Post-operative JOA scores increased(P

OBJECTIVE To evaluate the antibiotic susceptibility on coagulase negative staphylococci(CNS) in Xiangya Hospital and to investigate the role of slime in the resistance mechanism of biofilms.METHODS To isolate and identify CNS from clinical(specimens).The susceptibility of 15 antibiotics was tested by the disc diffusion method.The quantity of slime(produced) by CNS was measured by the colorimetric method.Slime was isolated from selected strains of CNS and analyzed by SDS-PAGE.The MICs to vancomycin,gentamicin and rifampin were determined with and(without) the addition of extracted slime by a standard microtiter method.RESULTS Of all these 15 antibiotics,the highest resistance to CNS was penicillin,followed by erythromycin and trimethoprim-sulfamethoxazole.CNS was more susceptible to ampicillin/sulbactam and rifampin.None was resistant to vancomycin.All of 158 CNS,except one strain,could produce slime.There was a statistical difference between the quantities of slime produced by CNS that produced high and low quantity slime.However,there was a non-statistical difference of resistance to these 15 antibiotics of above CNS. There was an increase in the MICs to vancomycin and gentamicin,but no in the MIC to rifampin,in the absence of 20mg/ml extracted slime.The extracted slime seemed to be similar to the glycosaminoglycans(GAG);it had mobility similar to that of chondroitin sulfate.CONCLUSIONS CNS can(produce slime) on some condition,universally,then to form biofilms.However,in vitro susceptibility testing(employed) cannot really reflect the susceptibility of bacteria in biofilms in vivo.Slime can increase the MICs to vancomycin and gentamicin because of interference with either the antimicrobial action of these drugs or the(perfusion) of these drugs through the medium to increase the resistance of biofilms.It does not affect the MIC to rifampin.

entrate graft can block pathologic process and improve the inclusion of femoral head and increase blood circulation of femoral head, which is beneficial to its recovery.

In view of the weakness of the teachers' strength, students' lack of interest and the lack of unity of teaching materials in the foreign language teaching, Oral Medicine College of Chongqing Medical University carried out the reform to the professional foreign language courses in the postgraduate education period by strengthening the preparation of special teaching materials, reinforcing teaching staff construction, reforming teaching methods and creating a learning environment. The results of teaching assessment by students and peer-reviewers show that reform has achieved good results, and aiming at the problems in the teaching practice we also put forward such improvement measures as strengthening the student-centered teaching method, promoting new teaching methods and optimizing curriculum assessment programs.

Objective To explore the rehabilitation for dysphagia in young patient after tracheotomy and cricopharyngeal achalasia with-out cough reflex. Methods A child was reviewed, who accepted tracheotomy after resection of cerebellar pilocytic astrocytoma for dyspha-gia. The features characterized as severe silent aspiration and failure of cricopharyngeus muscle relaxation. Therapies included Passy-Muir valve placement, breathing exercises, balloon dilatation, surface electromyography biofeedback, and electrical stimulation. Results The aspi-ration was observed when she drank thin liquid with weak cough reflex, and disappeared as eating thick liquid and paste food, with complete cricopharyngeus muscle opening, 7 weeks after treatment. She was removed the tracheotomy tube and nasal feeding tube 11 weeks after treatment, and got sufficient nutrition by fully oral intake. Conclusion The application of Passy-Muir valve and comprehensive swallowing training is helpful for patient post tracheotomy with silent aspiration in decreasing the risk of aspiration, improving cough reflex and prompt-ing swallowing function.

Objective To compare the diagnostic reliability of AO classification and Evans-Jensen classifications in X ray film and three-dimensional CT reconstruction images intertochanteric fractures, and explore advantage of the three-di?mensional CT. Methods A retrospective study was performed to evaluate 54 patients with intertochanteric fractures. Three orthopaedic surgeons were asked to make assessment of fracture classifications using X ray film and the three-dimen?sional CT images. Agreement test was performed to evaluate interobserver and intraobserver reliability for fracture classifica?tion. Results When X ray film was used, mean Kappa values of interobserver reliability for AO and Evans-Jensen classifi?cations between three surgeons were 0.597 and 0.571, that was medium consistency. While using three-dimensional CT to AO classification, lower Kappa value was 0.411, medium consistency. Evans-Jensen classification, Kappa value was 0.704, highly consistency. Each surgeon respectively using X ray film and three-dimensional CT, the mean Kappa values of AO and Evans-Jensen classification were 0.464, medium consistency and 0.191 (0.160-0.233), weak consistency. Conclusion Both classifications based on X ray film show moderate consistency, using three-dimensional CT does not improve the consis?tency of AO classification. The three-dimensional CT is not applicable in Evans-Jensen classification.

Distal radius fractures (DRFs) are one of the most common injuries in orthopaedics,accounting for up to 20％ of all fractures seen in the emergency room.At present,the optimal treatment of these fractures remains controversial.Although most DRFs can be treated non-operatively,such as immobilized by plaster,splint or brace,surgical management has become more and more popular with people's living standards improved and expecting better functional outcome.Surgical treatments for DRFs include percutaneous fixation with Kirschner wires,skeletal external fixation,open reduction and internal fixation,intramedullary nails,fixation using the mini-invasive approach,arthroscopy,and total wrist arthroplasty.Currently,open reduction with volar plate fixation is the most popular and widely way for DRFs,while a mini-invasive approach is a new reliable and reproducible procedure with few complications.Despite recently surgical treatment has become more and more popular,it is also unclear whether surgical intervention will produce better long-term outcomes.The aim of this paper is to present the studies in the literatures about the treatment for DRFs and an update of existing techniques.

Ulnar styloid fractures are commonly associated with distal radius fractures.It remains a surgical dilemma whether to fix the ulnar styloid or not.Some surgeons believe that management of the ulnar styloid fractures is imperative while others feel that they should be managed conservatively.Several clinical studies have concluded that the ulnar styloid fractures have no impact on the anatomic,radiographic,or functional results when accompanied with a distal radius fracture.Others have found they are associated with distal radioulnar joint (DRUJ) instability,concomitant triangular fibrocartilage complex (TFCC) tear,decreased range of motion,or decreased grip strength in the affected wrist.The purpose of this review was to evaluate the effect of associated ulnar styloid fractures on the distal radius fractures and to discuss the treatment of ulnar styloid fractures.