Objective To compare the curative effect of the different palm dorsal approach of open reduction and internal fixation for the treatment of distal radius fractures.Methods According to the stochastic indicator method,84 patients with distal radius fractures were divided into control group and observation group,42 cases in each group.The control group was treated with dorsal approach open reduction and internal fixation,while the observation group was treated by volar approach open reduction and internal fixation.The clinical curative effect was assessed,and indicators related to the operation and the fracture healing was recorded in detail.Postoperative complications of patients were analyzed during postoperative follow-up.Results The total effective rate of the observation group was 88.10%(37/42),which was significantly higher than 66.67%(30/42) of the control group(x2=5.509,P=0.019).Compared with the control group,the operation and hospital stay time were significantly shorter,intraoperative and postoperative blood loss of the observation group decreased obviously,and the differences were statistically significant(t=2.092,2.137,2.256,2.199;P=0.040,0.036,0.027,0.031).The Gartland-Weriey score and ulnar inclination of the observation group were (9.18±2.96)points and (10.52±2.64)°,which were significantly lower than those of the control group[(12.56±3.24)points,(16.22±2.87)°],while radial height[(11.61±2.87)mm]was higher than the control group[(10.92±2.65)mm],the differences were statistically significant(t=2.206,2.316,2.185;P=0.030,0.023,0.032).The incidence rate of complications of control group was 26.19%(11/42),which was higher than 9.52%(4/42) of the observation group(x2=3.977,P=0.046).Conclusion The curative effect of volar approach of open reduction and internal fixation in the treatment of distal radius fractures was better compared with dorsal approach.At the same time,it can effectively improve the operation indicators and fracture healing effect,in addition,it can effectively reduce the incidence of postoperative complications.

Objective To study the effect of lateral supramalleolar perforator flap for skin and soft tissue defect of lateral malleolus.Methods From January 2012 to December 2015,36 patients with soft tissue burn of ankle in the Traditional Chinese Medicine Hospital of Cixi were selected as study objects.The average wound area was 4 ～ 10cm.The average flap size was 5 ～ 13cm.There were 17 cases received skin flap of behind perforator of the lateral malleolus.There were 19 cases received skin flap of front perforator of the lateral malleolus.The effect of repair was observed.Results All flaps survived in 36 cases after operation.There were 7 cases of 2.6cm of blood stasis,and necrosis occurred in 2 cases which healed after dressing change.Transplantation of skin flap and the original skin had good adhesion,skin color and texture was similar to the surrounding skin during the follow-up period of 6 to 12 months.The survival time and walk time of the repair of anterior perforator flap were (2.20 ± 0.70) weeks,(4.70 ± 1.10) weeks,respectively,which were longer than those of the lateral retromalleolar perforator flap [(2.10 ± 0.80) weeks,(4.20 ± 1.10) weeks],but the differences were not statistically significant (all P ＞ 0.05).The American orthopaedic foot and ankle society(AOFAS) score of the anterior perforator flap was significantly lower than that of the lateral retromalleolar perforator flap,the difference was statistically significant[(77.47 ± 3.41) points vs.(80.12 ± 4.12) points,t =2.110,P ＜ 0.05].Conclusion Lateral supramalleolar perforator flap has significant effect for skin and soft tissue defect of lateral malleolus.The operation is simple,the success rate is high,it is worth to be popularized in clinical.

OBJECTIVE: To investigate the application value of fusion indocyanine green fluorescence imaging(FIGFI)in the surgical treatment of recurrent hepatocellular carcinoma.METHODS: From January 2015 to January 2018,theclinical data of 12 patients with recurrent hepatocellular carcinoma who received surgical treatment guided by three-dimensional visualization technology combined with FIGFI at Department of Hepatobiliary Surgery,Zhujiang Hospital,Southern Medical University were analyzed. High-quality thin-slice CT data were collected for three-dimensionalvisualization and reconstruction,individualized liver segmentation and preoperative surgical planning. FIGFI was used todefine the demarcation of tumors,to determine the extent of hepatectomy,and to detect small hepatocellular carcinomaand metastases during the operation. The use of FIGFI in combination with three-dimensional visualization imagesguided the precision hepatectomy. postoperative efficacy was observed by follow-up.RESULTS: All the 12 patientsunderwent successful three-dimensional reconstruction and liver resection. Preoperative CT revealed 12 lesions(80%);intraoperative FIGFI detected 15 lesions(100%);of the three newly discovered lesions,2 were hepatocellular carcinomaand 1 was cirrhosis nodule. The operation time was 267.5(183,345)minutes and the amount of bleeding was 287.5(62.5,513.5)m L. No severe complications such as abdominal hemorrhage,abdominal infection,bile leakage and liverfailure occurred postoperatively. No death occurred during the perioperative period. The median follow-up period was 29 (3-36)months; during the follow-up period, 1 casewas lost and 4 cases had metastasis or recurrence.All the patients were alive at the end of the follow-up.CONCLUSION: FIGFI is helpful to achieveanatomical, functional and radical hepatectomy inthe treatment of recurrent hepatocellular carcinoma.

Cyclic adenosine monophosphate(cAMP)is a “second messenger” that regulates cell signal transduction. Adenylyl cyclases(ACs)and phosphodiesterases(PDEs)can directly regulate cAMP level in cells and then regulate the downstream signaling pathways. Increasing intracellular cAMP level can inhibit inflammation and enhance smooth muscle relaxation, which is an effective strategy for the prevention and treatment of chronic obstructive pulmonary disease(COPD). This paper briefly summarizes the signaling pathways regulating cAMP and their mechanisms and related drugs in COPD therapy, hoping to provide references for further research and development of new target drugs which regulate cAMP for the prevention and treatment of COPD.