Objective:To compare short-term and long-term curative effect of modified double Kirschner wire open reduction and internal fixation (ORIF) and traditional surgery on patients with mallet fingers of avulsion fracture type.Methods:Eighty-five patients with mallet fingers of avulsion fracture type who were admitted to Yongkang Orthopaedic Hospital from January 2016 to October 2018 were enrolled. 45 patients received modified double Kirschner wire ORIF were included in the observation group, while 40 patients who underwent traditional extracting wire fixation were included into control group. The operation time, fracture healing time and complications were recorded. At 3 months after surgery, short-term curative effect was evaluated. After 1-year postoperative follow-up, long-term prognosis was evaluated by finger joint function scoring.Results:The operation time of observation group was shorter than that of control group ( P<0.05). The fracture healing time of observation group was shorter than that of control group ( P<0.05). The good rate of observation group was higher than that of control group (93.33% vs 77.50%) ( P<0.05). In finger joint function score, scores of finger strength, finger flexibility, effects on work and life, and total score in observation group were higher than those in control group ( P<0.05). There was no significant difference in pain degree or appearance satisfaction betwen the two groups ( P>0.05). There was no significant difference in incidence of postoperative complications between the two groups ( P>0.05). Conclusions:The modified double Kirschner wire ORIF for the treatment of avulsion fracture mallet finger has the advantages of simple operation, fast fracture healing and better long-term and short-term curative effect than the traditional wire extraction method.

Humans ; Magnetic Resonance Imaging ; Preoperative Care ; Rectal Neoplasms ; diagnosis

Objective: To investigate the value of lipid accumulation product (LAP) and visceral fat index (VAI) for prediction of metabolic syndrome (MS). Methods: Based on the 2018 Survey on Chronic Diseases and Risk Factors in Yantai City of Shandong Province, residents at ages of 45 years and older were sampled, and subjects' age, disease history, waist circumstance (WC), body mass index (BMI), blood pressure and blood lipid were collected to calculate LAP and VAI. MS was diagnosed with the a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity (JIS definition) and the recommended criteria proposed by the Chinese Diabetes Society (CDS) of Chinese Medical Association (CDS criteria), and the values of LAP and VAI for MS screening were evaluated using the receiver operating characteristic (ROC) curve analysis. Results: Totally 9 366 subjects were enrolled, including 4 340 men (46.34%) and 5 026 women (53.66%), and had a mean age of (54.49±9.73) years. According to the CDS criteria, the prevalence of MS was 24.58%, and LAP and VAI showed areas under the ROC curve (AUC) of 0.837 (95%CI: 0.828-0.846) and 0.751 (95%CI: 0.739-0.762), sensitivities of 78.82% and 63.31% and optimal cut-off values of 44.64 and 1.86 for screening of MS. According to the JIS definition, the prevalence of MS was 35.26%, and LAP and VAI showed AUC values of 0.842 (95%CI: 0.834-0.850) and 0.790 (95%CI: 0.780-0.800), sensitivities of 75.73% and 68.42% and optimal cut-off values of 42.01 and 1.67 for screening of MS. Conclusions Both LAP and VAI are effective for screening MS among middle-aged and elderly residents, and LAP presents a higher accuracy than VAI.

Objective:To explore the clinical effect of Huayu-Ningkun liquid enema and external application of dreg for treating chronic pelvic inflammatory disease. Methods:A total of 106 patients with chronic pelvic inflammatory disease who met the inclusion criteria in the gynecological outpatient department of Beijing Hospital of Integrated Chinese and Western Medicine from January 2018 to December 2019 were divided into 2 groups by random number table method, with 53 patients in each group. The control group was treated with conventional western medicine therapy, and the observation group was combined with Huayu-Ningkun liquid enema and external application of drug residue on the basis of the control group. TCM symptom scores were performed before and after treatment, and the Quality of Life of patients was evaluated by Generic Quality of Life Inventory-74 (GQOLI-74). Serum CRP and TNF-α levels were detected by ELISA, and adverse reactions during treatment were recorded. Results:The total effective rate was 96.2% (51/53) in the observation group and 83.0% (44/53) in the control group, and the difference between the two groups was statistically significant ( χ2=4.970, P=0.026). After treatment, the TCM symptom scores of the observation group was significantly lower than that of the control group ( t=8.205, P<0.01). The scores of physical function, mental function, material life and social function were significantly higher than those in the control group ( t value were 7.503, 8.786, 7.798, 9.353, all Ps<0.001). After treatment, the levels of serum CRP (4.52 ± 3.46 g/L vs. 8.23 ± 3.35 g/L, t=5.608) and TNF-α (1.00 ± 0.35 μg/L vs. 1.52 ± 0.28 μg/L, t=14.551) in the observation group were significantly lower than those in the control group ( P<0.01). Conclusion:The Huayu-Ningkun liquid enema and drug residue external application combined with western medicine can relieve the symptoms, reduce the level of inflammatory cytokines, improve clinical efficacy of the patients with chronic pelvic inflammatory disease.

Emphysematous cystitis is a rare inflammation of the bladder, which can be life-threatening in severe cases. A senior gentleman with emphysematous cystitis was recently admitted to our hospital. He got bilateral renal hydronephrosis and bilateral terminal pneumatosis of the ureter. The comorbidity was prostatic hyperplasia and diabetes. After indwelling catheter , glucose levels control and anti-infection treatment for 3 days, the repeated CT showed the gas inside the bladder the end of ureter decreased significantly. The blood routine, urine routine, renal function was better than before. The patient was instructed to continue anti-infection treatment. The above laboratory examination indicators returned to normal after a week's re-examination.

Transcatheter arterial chemoembolization (TACE) has been widely applied in palliative treatment of unresectable primary and metastatic liver cancer,and its efficiency and safety also have been widely acknowledged.However,there is a wide range of related complications,such as upper gastrointestinal hemorrhage,liver failure,pulmonary embolism,embolic cholecystitis and so on.As a serious complication of TACE,bile duct injury has been reported intermittently since the introduction of hepatic arterial embolization therapy.However,the exact pathogenesis,predisposing factors and clinical implications of the injuries remain to be clarified.As we find,by far there is no literature review about the bile duct injury after TACE for liver malignant tumors both at home and abroad.Thus the purpose of our study was to discuss such current issue of bile duct injury,and 26 articles have been included and analyzed.

Objective To evaluate the short-term results of ARCH plate in cerical expansive open-door laminoplasty(ELAP)for OPLL.Methods From June 2010 to September 2011,a total of 12 cases with OPLL underwent open-door ELAP by ARCH plate fixation and were followed up in our hospital.8 cases were males and 4 cases were female.The average age was 60.5 years.The neurological effect was evaluated by use Japanese Orthopedic Association(JOA)scoring criteria for cervical myelopathy.The ana-tomical effect was analyzed by compare roentgenogram and CT before and after surgery.Results The JOA scores were improved for 39% after the operation,while the saggital diameters of the cervical spinal canaldural after operation was enlarged for 82%(P<0.05).X-ray films and CT scan after operation that there was no occurrence of re-close of door,there was no occurrence of anchor loosing.Conclusion For OPLL,ELAP using ARCH plate fixation bring less occurrence of re-close of door,slight postoperative neck AS,and satisfactory clinical outcomes.

Based on the investigation and analysis of industry dynamics of health maintenance Applications (APP) of Traditional Chinese Medicine (TCM),the paper designs and develops health maintenance APP of TCM,and describes its architecture,operating principle,functions,innovativeness,applicability scope,etc.

Objective To compare the short- and long- term effects and safety of endoscopic balloon dilatation vs. placement of specially designed reclaimable self-expanding anti-reflux esophageal stents for achalasia. Methods A total of 129 patients with achalasia were divided into 2 groups to receive either endoscopic scopic balloon dilatation(,l=63)or endoscopic placement of specially designed reclaimable self-expandinganti-reflux esophageal stents (n = 66). The dysphagia symptom scores were recorded before and 1-month,6-month and 12-month after the procedure, respectively. The change in width of esophagus, procedure related complications, length and costs of hospitalization were also analyzed. Results Dysphagia symptom score was significantly decreased after the treatment in both groups (P < 0.05). The effective rates evaluated at 1-month, 6-month and 12-month after the procedure in balloon dilatation group were 100. 0% , 96. 7% and 91.5% , respectively, which in stenting group were 100.0% , 98. 0% and 97.1% , respectively. There was no significant difference in changes of symptom score at 1-month and 6-month after treatment between the 2 groups (P > 0.05) , while at 12-month after treatment, the decrease of symptom score in stenting group was significantly higher than that in balloon dilatation group (P<0. 05). After the treatment, the significant widening of the stricture and narrowing of the dilated esophagus were achieve in both groups (P < 0.05),while no significant difference between these 2 groups was observed in changes of width (P > 0. 05). Procedure related complications in balloon dilatation group included esophageal perforation (n =1) and upper gastrointestinal bleeding (n=4) , which was not occurred in stenting group, but complications included hyperplasia of granulation tissue (n = 1), stent dislocation (n =2) and defulvium (n = 1) was observed inthe latter group. The length of hospitalization was similar in 2 groups (P > 0. 05) , and the cost of hospitalization in stenting group was significantly higher than that of balloon dilatation group (P < 0. 05). Conclusion Compared with endoscopic balloon dilatation, the specially designed reclaimable self-expanding antireflux stents is a more ideal method for achalasia, with similar short-term effect, but better long-term effect and safety.

Objectives:To analyze the clinical characteristics of patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) and identify the risk factors for death.Methods:The clinical data of 60 patients undergoing ECPR admitted to our hospital and Hangzhou First People's Hospital from September 2014 to September 2019 were retrospectively analyzed. The patients were divided into the survival group and the death group. The clinical data of the two groups were compared to explore the risk factors related to death. COX regression analysis was used to identify the risk factors for death.Results:Sixty patients undergoing ECPR were included in our study, of them, 16 (26.7%) cases were out-of-hospital cardiac arrest (OHCA) and 44 (73.3%) cases were in-hospital cardiac arrest (IHCA). The mortality of OHCA patients was higher than that of IHCA patients (87.5% vs. 56.89%, P < 0.05), and the duration from CPR to ECMO installation in the death group was longer than that in the survival group [(105.4±105.1) min vs. (53.0±28.5) min, P < 0.05]. Compared with the survival group, patients in the death group had higher troponin and glutamic oxalacetic transaminase and lower PH and lactate ( P < 0.05). The median survival time of the 60 patients was 42 days. Out-of-hospital cardiac arrest, high SOFA score before ECMO, high-dose norepinephrine, pulmonary infection during ECMO support and long ECMO support time were independent predictors of patients’ death. Conclusions:Risk factors associated with patients’ death undergoing ECPR are out-of-hospital cardiac arrest, high SOFA score before ECMO, high-dose norepinephrine, long duration from CPR to ECMO installation, pulmonary infection during ECMO support and long ECMO support time.