Objective To study how to use the machine of B.BRAUN's Diapact continuous renal replacement therapy (CRRT) to achieve multiple models of plasma treatment by analyzing the characteristics of the machine.Methods Based on the machine of B.BRAUN's Diapact CRRT,assisted by extra single pump,the pipeline connection of the machine was reformed and the appropriate parameter was reset.Results After the reconstruction,the new equipment could succeed in achieving special plasma treatment such as double filtration plasmpheresis (DFPP)and plasma adsorption (PA).Conclusions The reconstructed equipment can attain special plasma treatment.Compared with plasma exchange (PE),the equipment has some characteristics such as few syndromes and without external plasma.According to its safety and stability,this new method is suitable for clinical application.

Objective To evaluate the short and mid-term effects of fixing comminuted posterior acetabular wall fractures with structural autologous iliac bone graft combined with mini screws.Methods From January 2010 to January 2014,29 patients with comminuted posterior acetabular wall fracture were treated by structural autologous iliac bone graf combined with mini screws.They were 21 males and 8 females,with a mean age of 44.2 years (range,from 22 to 58 years).The mean time form injury to operation was 7.8 days (range,from 1 to 25 days).The operations were performed through the Kocher-Langenbeck approach,with the patients in the lying position on the uninjured side.The fragments were reduced and fixed by mini screws and the ischemic ones were removed.Structural autologous iliac bone graft was used to reconstruct the posterior wall of acetabulum before a reconstruction plate was applied to compress and maintain it.The functional outcomes were evaluated by the modified Merle d'Aubigne and Postel clinical grading system at the last follow-ups.The radiographs were graded according to the Matta criteria.Results By the Matta criteria,10 cases achieved excellent reduction,16 good reduction,and 3 poor reduction,giving a good to excellent rate of 89.7％.Of this series,29 patients were followed up for 31.5 months on average (range,from 12 to 48 months).By the modified Merle d'Aubigne and Postel criteria,the functional recovery was rated as excellent in 16 cases,good in 9,fair in 3 and poor in one,giving a good to excellent rate of 86.2％.Two cases developed femoral head necrosis according to the magnetic resonance imaging 18 months postoperation.Three patients developed traumatic arthritis two years postoperation.Five patients developed heterotopic ossification postoperation,with no obvious clinical symptoms.Two patient with injury to the sciatic nerve recovered 4 months postoperation.Conclusions Structural autologous iliac graft combined with mini screws can reconstruct the integrity and stability of the fractured acetabular posterior wall,avoiding osteonecrosis of the acetabulum.This surgical technique is effective and safe in treatment of comminuted fracture of the acetabular posterior wall.

Objective To analyse pathogenesis, types, diagnosis and operation methods of adult intussusception. Methods Clinical data of 150 patients with adult intussusception were reviewed retrospectively . Results Symptom included paroxysmal bellyache (90 0%), abdominal mass (64 7%), nausea and vomit (58 0%), hematochezia (20 7%), constipation (10%) and symptom triad of bellyache , mass and hematochezia (15 3%). Tumor, inflammation, Meckel′s diverticulum and mobile cecum were main cause for intussusception. All 150 patients received operation, 147 patients were cured and 3 patients died. Conclusions Most patients of adult intussusception had pathological basis. The result of surgical therapy is good.

Objective To summarize the experience in prevention and treatment of iatrogenic bile duct injury Methods Clinical data of 112 cases with iatrogenic bile duct injury in ten hospitals of Songhua river drainage area from January 1978 to January 2003 were analyzed retrospectively Results The main cause of iatrogenic bile duct injury was wrong identifying the anatomy of the Calot′s triangle before cholecystectomy accounting for 55 4% (62/112) Diagnosis depended on clinical features, celiac puncture and imaging examination Ultrasonography was among the most sensitive diagnostic means (diagnostic rate=97 5%) Six types of injury were identified according to their locations and type Ⅲ damage was most common in clinical practice (92/112) The curative rate in this group was 95 5% (107/112) Eighty seven cases (77 7%) underwent Roux en Y choledochojejunostomy, with cure rate of 94 3%(82/87) Conclusion Iatrogenic bile duct injury prevention lies in identifing the topography of extrahepatic bile ducts Roux en Y choledochojejunostomy is usually the therapy of choice

The elbow is more susceptible to motion loss than other joints after trauma,and elbow stiffness leads to functional impairment in the upper limb and interferes with daily activities.Open arthrolysis is the most common and classical treatment for post-traumatic elbow stiffness.In this paper,we review the treatment protocols like preoperative clinical evaluation,arthrolysis strategies and postoperative rehabilitation program for post-traumatic elbow stiffness,discuss relevant issues and assess their prospects.

Objective To evaluate the effectiveness and safety of acupuncture in patients with Major Depressive Disorders.Methods Search the database for relevant literature published before April 15,2023.Select randomized controlled trial that meeting the enrollment criteria,evaluate the quality of the literature and classify before meta-analysis systematic evaluation.Results 15 RCTs are included in this study,with a total of 1077 patients.The results showed that acupuncture treatment,compared with antidepressants alone,The score of Hamilton Depression Scale(HAMD)in patients with liver-qi depression disorder[MD=-0.73,95%CI(-1.22,-0.24),P<0.05],the score of TCM Syndrome Scale[MD=-1.89,95%CI(-2.35,-1.44),P<0.001],effective rate[RR=1.09,95%CI(1.03,1.153),P=0.001]and TESS score[MD=-2.76,95%CI(-3.68,-1.85),P<0.001]were statistically significant.Compared with fluoxetine hydrochloride,the effective rate of HAMD scale score was statistically significant[RR=1.07,95%CI(1.01,1.14),P<0.05].Conclusion Compared with antidepressants alone,acupuncture therapy has the advantages for the improvement of HAMD score in patients,the improvement of Traditional Chinese medicine symptoms,and significantly less adverse effects than those in the control group.Through this study,it is considered that acupuncture can be a safe and effective treatment modality.However,due to the quantity and quality of the included literature,the above conclusions still need to be verified by more high-quality clinical trials.