The instability of elbow is common among patients who suffered f ro m acute fracture or dislocation or from chronic strain. It is crucial to correct ly deal with the acute injury of the elbow, otherwise it would become chronic in stability of the elbow which is difficult to treat. This paper reviews the liter ature about the clinical representation, diagnosis and treatment of elbow instab ility. The surgical principle is to convert a complex fracture-dislocation patt ern into a simple dislocation pattern. Surgery should try to restore the anatomi c structure of the elbow, including articular surfaces and soft tissues. In inju ries to the ulnohumeral joint, reconstruction of the lateral tissues is the key to restoring joint stability. The premier treatment of recurrent instability of elbow is surgical treatment.

Objective:To analyze the clinical outcomes of the locking compression plate(LCP) fixation for the unstable sacral fracture.Methods: Nine patients with unstable sacral fracture were treated with locking compression plate fixation in our department,including 7 males and 2 females,with an average age of 34.8 years(ranged from 25 to 49 years).AO classification system found 1 B_(1),4 B_(2),2 B_(3) and 2 C_(1) type.Dennis classification found 6 Ⅰ section sacral fracture and 3 Ⅱ section sacral fracture.Incisions(6-8 cm) were made from each side of superior iliac spine to ipsilateral inferior iliac spine along iliac crest.After the fractures or dislocations were exposed and reduced,LCPs were chosen and remodeled.The iliosacral posterior ligaments were restored if injured.The LCP was pushed cutaneously to the other incision,placed on both dorsal ilia and fixed with locking screws.Each side of postal LCP was fixed with 3 locking screws for effective fixation.The reduction and fixation of fractures or dislocation were assured by radiostereoscopy.The operations lasted 45 min averagely(ranged from 30-80 minutes) and no patient needed blood transfusion.The average X-ray exposure period was 4 min(from 2-10 minutes).Results: All the patients were followed-up for a mean of 13.8 months,ranged from 6 months to 21 months.There was no iatrogenic nerve injury.The function and the feeling of sacroiliac joint and low extremities recovered to normality.According to the Majeed standards,the results were excellent in 4,good in 4,and fair in 1.Conclusion: The locking compression plate fixation is a simple and effective treatment for the unstable sacral fractures,with less trauma and complications.

Objective To explore the clinic results of the locking compression plate fixation for injuries at the posterior ring of pelvis. Methods 5 patients with injuries at the posterior ring of pelvis were treated with locking compression plate fixation. 2 of them resulted from crashing, 2 from crushing and 1 from falling. They included 4 males and 1 female and their average age was 35.6 years. According to AO classification system, there were 1 type B1, 2 type B2, 1 type B3 and 1 type C1; according to Dennis classification system, there were 4 section I fractures and 1 section II fracture. Results All the patients were available at follow-up, with a mean period of 5.8 months (ranging from 3 to 12 months). The average intraoperative time was 50 minutes (ranging from 30 to 80 minutes), and no patient underwent blood transfusion because the intraoperative blood loss was only 100 to 400 mL. There was no iatrogenic nerve injury and all the incisions healed during the primary procedure. The function and sense of sacroiliac joint and low extremities recovered to normal. Conclusion The locking compression plate fixation is one of the effective methods for treatment of injuries at the posterior ring of pelvis, for it is simple and minimally traumatic, and has a low rate of complications.

ObjectiveTo investigate atlantoepistrophic imaging features of patients with vertigo of cervical syndrome.Methods74 patients with vertigo of cervical syndrome were checked by photographs of cervical vertebrae of A-P position, lateral position and mouth open position, some patients were checked by CT three-dimensional reconstruction and/or MRI vertebral arteriography.ResultsImaging examination of these patients showed that physiolgical curvature of cervical vertebrae became straightened, width of both lateral masses of atlas was inequality, space of both lateral masses of atlas to odontoid process of vertebra dentata was also inequality, and inferior articular surface of lateral mass was not parallel with superior articular surface of axis. The CT could display the side displacement and anterior or posterior rotation of lateral masses of atlas. The cervical MRI vertebral arteriography could display the effect of side displacement and rotation of lateral masses of atlas on vertebral artery. If side displacement or rotation of vertebral artery occurred, the diameter of artery decreased.ConclusionThe diseased region of vertigo of the cervical syndrome is the atlas and axis, especially the side displacement and anterior or posterior rotation of the atlas.

目的探讨应用非手术方法治疗老年患者腰椎管狭窄症的疗效。方法对74例老年(>60岁)腰椎管狭窄的患者采用手法矫正椎体的假性滑移、药物治疗、适当的腰背肌功能锻炼综合治疗。随访至少2年。采用自定标准评定疗效。结果优(无疼痛及间歇性跛行,无功能限制,不用止痛剂)34例,良(偶然疼痛及间歇性跛行,轻度功能受限,偶尔使用止痛剂)27例,一般(中度的疼痛及间歇性跛行,中度功能限制,无运动,经常使用止痛剂)11例,差(中度每天疼痛及间歇性跛行,或偶尔严重疼痛,每天日常生活活动受限,应用强止痛剂)2例。结论对老年腰椎管狭窄症采取综合的非手术方法能取得一定疗效。

In April 10, 2010, an earthquake measuring magnitude 7.1 shocked Yushu County,Qinghai province. For medical rescue, the National Earthquake Disaster Emergency Rescue Team was sent to Yushu right away. Rescue work in Yushu was faced with such difficulties as short preparative time, heavy workload, high exposure to various acute high altitude diseases (AHAD), and a number of other diseases frequently found on the cold plateau. To ensure the rescue work a success, the team took a series of measures including efficient preparative procedure, scientific and logical procedure in the emergency medical aid operations, reliable and effective handling of AHADs, along with sufficient self protection for team members.

ObjectiveTo analyze the classifications of the abnormalities of cervical curvature and its treatments with manipulation. Methods209 patients with cervical lordosis were analyzed. The abnormalities of the cervical curvature were classified as over-curvature (>45°), hypo-curvature (0°～30°), the straightened cervix (0°), backward curvature(0°～―20°), multiple curvatures (the cervical curvature showed "S" shaped). The C_5 subluxation were restored with manipulation in patients with hypo-curvature and straightened cervix, or other vertebra subluxation in multiple curvatures. Results1~4 yeared follow-up, 127 cases were excellently well being, 59 were well being, 23 were improved.ConclusionManipulation is effective on abnormalities of cervical curvature.

Objective To investigate the changes of serum C reactive protein (CRP),D-two polymer (D-D) and calcitonin (PCT) in patients with severe chronic obstructive pulmonary disease ( COPD) and its clinical value. Methods A retrospective analysis was conducted in 146 patients with severe COPD at acute attack in Tongji Huangzhou Hospital of Huazhong University of Science and Technology from December 2015 to December 2017.In addition,146 cases of COPD at remission stage (remission group) and 80 healthy subjects (control group) who were admitted to the hospital during the same period were selected.The serum levels of D -D,hs-CRP and PCT were compared among the three groups.At the same time,the levels of serum D-D,hs-CRP and PCT in patients with no bacterial infection or different pulmonary function classification were compared .Results The serum levels of D-D, hs-CRP and PCT in the acute group [(1 927.4 ±83.4) μg/L,(39.3 ±3.2) mg/L,(5.8 ±1.7) ng/mL] were significantly higher than those in the remission group [(314.2 ±69.2)μg/L,(16.4 ±3.4)mg/L,(1.8 ±0.7)ng/mL], which in the remission group were also significantly higher than the control group [(231.7 ±58.5) μg/L,(3.8 ± 1.5)mg/L,(0.4 ±0.1)ng/mL],the differences were statistically significant (F＝35.487,11.266,6.752,P＝ 0.001,0.005,0.000).The serum levels of hs -CRP and PCT in the acute phase combined with bacterial infection group[(41.4 ±1.7) mg/L,(6.4 ±1.4) ng/mL] were higher than those in the non bacterial infection group [(36.3 ±1.2)mg/L,(5.0 ±1.0)ng/mL](F＝16.541,4.467,P＝0.000,0.011),but there was no statistically significant difference in D -D level ( P ＞0.05).There were statistically significant differences in serum D -D, hs-CRP and PCT levels among patients with different pulmonary function classification [serum D-D:(2 083.5 ± 88.3)μg/L vs.(1 727.3 ±71.3)μg/L vs.(1 523.5 ±67.3)μg/L;hs-CRP:(63.8 ±19.5)mg/L vs.(29.5 ± 10.4)mg/L vs.(10.6 ±3.2) mg/L;PCT:(6.2 ±1.3) ng/mL vs.(3.4 ±0.9) ng/mL vs.(1.3 ±0.4) ng/mL] (F＝34.493,15.488,6.567,P＝0.000,0.001,0.018),and the higher the pulmonary function classification ,the higher the above indicators(all P＜0.05).Conclusion The levels of serum CRP,D-D and PCT in patients with severe COPD at acute attack are significantly increased ,and the increase of the patients with bacterial infection is more obvious,and the index level is positively correlated with the classification of lung function ,which can provide a reference for clinical practice.