OBJECTIVETo investigate the clinical effects of bone setting manipulation on simplified operation and swelling reduction in treating calcaneal fractures.

METHODSFrom December 2005 to November 2010, 42 patients with calcaneal were reviewed, including 25 males and 17 females, ranging in age from 18 to 74 years, with an average of 41.4 years. Twenty patients had fractures in the left and 22 in the right. Twenty-three patients were treated with anatomical plate fixation, 19 patients were treated with Kirchners wires or cannulated screws fixation. The average period of swelling in soft tissue, joint function and complications were evaluated.

RESULTSForty-two patients were followed up, and the duration ranged from 3 to 18 months, with a mean of 8.3 months. The pain was markedly relieved at the next day after reduction, and the swelling was relieved in 3 to 5 days. The operative was simplified and the average operative time was 90 minutes. The swelling was relieved in 4 to 7 days after the operation, and the necrosis of skin was not found. The average postoperatively Böhler angle was (31 +/- 3.2) degrees. Gissane angle was (112 +/- 5.3) degrees. Calcaneal width was (30.2 +/- 0.89) mm. According to Maryland foot function score system, 16 patients got an excellent result, 18 good, 6 fair and 2 bad.

CONCLUSIONThe operation is simplified, and skin complications decrease, as well as the detumescence period is shortened.

Adolescent ; Adult ; Aged ; Calcaneus ; surgery ; Combined Modality Therapy ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; therapy ; Humans ; Male ; Middle Aged ; Musculoskeletal Manipulations ; Young Adult

Objective:To investigate the effects of dexmedetomidine and urapidil on postoperative extubation stress response, postoperative shivering, and cerebral oxygen metabolism in patients with hypertensive intracerebral hemorrhage.Methods:A total of 120 patients with hypertensive intracerebral hemorrhage admitted to the Seventh People′s Hospital of Hebei Province from January 2021 to December 2022 were selected as the research subjects. They were randomly divided into an observation group (60 cases) and a control group (60 cases) according to the random number table method. All patients underwent intracranial hematoma removal surgery under general anesthesia combined with bone flap decompression surgery for treatment. The observation group patients received sedation and analgesia with dexmedetomidine and urapidil after surgery, while the control group patients received sedation and analgesia with dexmedetomidine after surgery. The differences in vital signs, stress indicators, cerebral oxygen and cerebral glucose metabolism, and adverse reactions between two groups of patients were compared.Results:There was no statistically significant difference in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and bispectral index (BIS) between the two groups after entering the room (T 0) and before anesthesia medication (T 1) (all P>0.05). The HR, SBP, DBP, and BIS of the observation group were significantly lower than those of the control group at extubation (T 2), immediately after extubation (T 3), 1 minute after extubation (T 4), and 3 minutes after extubation (T 5), and the differences were statistically significant (all P<0.05). There was no statistically significant difference in various stress indicators between the two groups of patients at T 0 (all P>0.05), while the stress indicators of the observation group were significantly lower than those of the control group at T 5 (all P<0.05). There was no statistically significant difference in the cerebral oxygen uptake rate (CERO 2) and cerebral arteriovenous blood glucose difference (AVDG) between the two groups of patients at T 0 (all P>0.05), while the CERO 2 and AVDG in the observation group at T 5 were significantly higher than those in the control group (all P<0.05). There was no statistically significant difference in the incidence of hypoxemia, hypotension, and bradycardia between the two groups of patients after surgery (all P>0.05). The incidence of postoperative shivering in the observation group was lower than that in the control group ( P<0.05). The Glasgow Coma Index of both groups of patients after surgery was higher than that before surgery (all P<0.05), and there was no statistically significant difference in Glasgow Coma Index between the two groups before and after surgery (all P>0.05). Conclusions:Dexmedetomidine and Urapidil have significant improvement effects on postoperative extubation stress response, postoperative shivering, and cerebral oxygen metabolism in patients with hypertensive intracerebral hemorrhage. It is recommended to promote them clinically.

With the improvement of living standards,at least a quarter of the global population has non-alcoholic fatty liver disease(NAFLD),which is considered to be an important cause of the increased incidence of hepatocellular carcinoma(HCC)in recent years.Finding effective means for disease prevention and/or treatment largely relies on deep understanding of the mechanisms of NAFLD to HCC,which needs to con-struct the stable experimental models to simulate the entire process of disease progression in human NAFLD-HCC.This paper summarizes the animal models which are currently used to study NAFLD-HCC and their ad-vantages and disadvantages,in order to provide a basis for the selection of animal models and accelerate the transition from basic study to clinical study.

Objective To establish a Nomogram predictive model for Neonatal Sepsis(NS)based on the general characteristics and initial complete blood count of neonates.Methods Retrospective analysis was conducted on the clinical data of newborns who were admitted for the first time to NICU and completed blood routine examination after admission in the MIMIC Ⅲ database.The LASSO-Logistic regression was used to investigate the prediction factors of NS,and then Nomogram prediction model was established.Internal validation was performed using boot-strap resampling with 1000 iterations.External validation of the model was performed using the data from newborns admitted to the First Affiliated Hospital of Zhengzhou University.We evaluated the predictive performance by Area Under the Receiver Operating Characteristic Curve(AUROC),C-index,calibration curve,and decision curve analysis(DCA).Results Among the 3,001 neonates,185 were diagnosed with NS.The Nomogram model was con-structed based on indicators such as respiratory distress syndrome,gestational age,birthweight,and initial hemato-logical parameters(red blood cell count,white blood cell count,lymphocyte percentage,neutrophil percentage),exhibiting good predictive performance with an AUROC of 0.860.Satisfactory predictive abilities were confirmed through both internal and external validation.Conclusion This study developed and validated a well-performing Nomogram prediction model.With simple parameters,it can help clinicians identify newborns at high risk early.