Objective To explore key points of nursing in treatment of tibial bone defect by united Ilizarov technology and bone transport. Methods A total of 12 patients treated tibial bone defect with combined Ilizarov technology and bone transport were retrospectively analyzed and summarized. Results All 12 patients were followed up for 5 to 24 months. Their average bone healing time was (9. 4 ± 2. 6) months, and average external fixation removal time was (10. 6 ± 2. 6) months. In one case, a little infection happened to the nail trail; after removal of crusts, the local part was cleaned with 75% alcohol cotton swab and kept dry, then the infection became better 2 days later. In another case, nonunion happened between the bone transport segment and the distal segment, so bone graft was done again. 2 cases of limb pain became better after delaying bone transport. No patients had complications due to nursing care. Conclusions Application of Ilizarov technique combined with bone transport on the treatment of tibial bone defect has advantages like small trauma, quick bone healing, equal length of lower limbs, and flexible knee joints. To guarantee operation effect and to improve patients′satisfaction, what is needed is postoperative observation and nursing of complications, psychological nursing, nursing in bone transport period, functional exercise and discharge guidance.

Objective:To investigate the correlation between the enhancement characteristics in arterial phase and the prognosis of patients with massive intrahepatic cholangiocarcinoma (IMCC).Methods:The imaging and clinical data of 92 patients with IMCC who were pathologically confirmed and underwent enhanced MRI or CT in Central Hospital of Lishui from June 2004 to February 2019 were retrospectively analyzed. According to the enhancement pattern of the primary lesion in the arterial phase, patients were divided into rich arterial blood supply group （17 cases） and deficient arterial blood supply group （75 cases）. The clinical data and imaging features of these patients were studied. Differences between measurement data and count data between the two groups were compared using t test and Fisher test. Kaplan-Meier analysis and log-rank test were used to analyze overall survival. The Cox regression multivariate analysis was used to study the relationship between the variables and the risk of death. Result:The enlargement of lymph nodes, long diameter of the primary lesion, CA19-9, treatment and HPD around the primary lesion in arterial phase were statistically different in the two groups ( P<0.05), others were no statistical difference. CA19-9>200 U/ml, lymph node enlargement, HPD around the primary lesion in arterial phase and deficient arterial blood supply were independent factors for the prediction of prognosis in IMCC patients with surgery ( P values were 0.008, 0.002, 0.049 and 0.005, respectively). Lymph node enlargement and deficient arterial blood supply were independent risk factors for the prediction of prognosis in IMCC patients with surgery ( P values are 0.049 and 0.045, respectively). Conclusion:The blood supply characteristics of arterial phase are independent factors for the prognosis of patients with IMCC.