Objective To explore the effects of dialectical nursing on recurrent oral ulcers in children. Methods One hundred and eighty-eight cases of children with recurrent oral ulcer hospitalized from March 2013 to June 2015 were randomized into study group and control group using random digit table with 94 cases in each group. The control group was intervened with the modern medical care pattern and the study group was with dialectical nursing care of Chinese medicine besides the modern medical care pattern. The two groups were compared in terms of the curative effect, time for ulcer healing, pains and level of the children′s and parents′satisfaction. Results The curative effect in the study group was significantly better than that of the control group (P<0.01). The time of the study group was shorter than that of the control one (P<0.001). The level of pains was lower but the degree of satisfaction was higher than that in the control group (all P<0.01). Conclusions The dialectical nursing care combined with modern medical care pattern is effective in treating recurrent oral ulcers in children. It can shorten the healing time and enhance the satisfaction. It can have high value of clinical application and promotion.

Objective To compare the treatment effectiveness of AO/ASIF proximal femoral nail (PFN) and proximal femoral nail antirotation (PFNA) in treatment of intertrochanterie fractures. Methods A retrospective study was done on 233 patients with intertroehanteric fractures treated from August 2004 to December 2006. The patients were divided into PFN group (188 patients) and PFNA group (45 patients) for comparing operative procedures and postoperative functional recovery. Results There was statistical difference in aspects of incision length, blood loss and operation time between two groups. The follow-up for 22.8 months showed excellence rate of 89.9% in PFN group and 91.1% in PFNA group, with statistical difference (X2 = 0.06, P > 0.05). There occurred hip varus in one patient and antirotation nail cutting-out in two in PFN group, which was not found in PFNA group. Conclusion PFN and PFNA are both good choices for treatment of intertrochanteric fractures. Compared with PFN, PFNA has more advantages in reducing operation time and blood loss especially for the eider patients with osteoporosis.

Objective To study the survival status of very elderly patients with intertrochanteric fracture admitted in hospital and its risk factors.Methods Clinical data of 54 patients with intertrochanteric fracture aged 90 years and over admitted in hospital from Jan.2006 to Dec.2013 were retrospectively analyzed.5 patients were lost to follow-up.The survival status of patients was analyzed.Results Patients were followed up until January 2015.The period of follow-up ranged from 85 months to 0.2 months,with an average follow-up of 33.3 months.17 cases were survived.Harris scores were(61.2 ± 10.6).The overall 1-,3-,5-year survival rates were(0.88 ± 0.05),(0.35 ±0.08),(0.18 ± 0.08),respectively.The mean and median survival times were (33.3 ± 4.6) months and(25.0±5.4) months.Cox proportional hazard regression model showed that American Society of Anaesthesiologists(ASA) score,operation time and the number of comorbidities were the risk factors for the survival time of very elderly patients with intertrochanteric fracture (all P ＜0.05).Conclusions Compared with conservative treatment,surgical treatment can increase the survival time of the elderly patients with intertrochanteric fracture.ASA score,operation time and the number of comorbidities may be the risk factors for the survival time of very elderly patients with intertrochanteric fracture.

Objective:To analyze the etiology of patellofemoral pain syndrome (PFPS) in basketball players and the effect of isometric exercise of the quadriceps femoris .Methods:A total of 20 basketball players from Shanghai sports bureau with PFPS were selected as research group ,and 28 healthy player without PFPS were chosen as control group .The differences regarding the Q‐angle and the moving track of patella between the 2 groups were analyzed .The training method in the research group consisted of quadriceps femoris isometric and isotonic contraction while that in the control group was isotonic contraction .The incidence rate of patellofemoral pain during the training ,as well as the effect of two kinds of training on the quadriceps femoris , was analyzed .Results:There was no significant difference regarding Q‐angle between the 2 groups .The incidence rate of patella maltracking in the research group was higher than that in the control group(P< 0 .05) .There was no significant difference regarding the incidence rate of patellofemoral pain during the training between the two groups . There was no significant difference regarding the force change of quadriceps femoris after training between the two groups ,however ,the muscular endurance change in the research group was lower than that in the control group(P< 0 .01) .Conclusions:The occurrence of PFPS in basketball player was not significantly related to Q‐angle ,however ,it was related to patella maltracking . Comparing to the isotonic exercise ,the training method consisting of isometric and isotonic contraction can achieve a similar effort regarding muscle force ,but muscular endurance .

Objective:To explore the accuracy of CT three dimensional reconstruction technique for the diagnosis of tibia shaft fracture accompanied by ankle injury .Methods:Both X‐ray examination and three dimensional CT scanning were conducted for the 117 patients with closed tibia shaft fracture ,who went to Zhongshan Hospital of Fudan University ,before surgery .The numbers of patients ,who were diagnosed with tibia shaft fracture accompanied by ankle injury ,were compared between the two examination methods .Results:Nineteen patients with tibia shaft fracture were diagnosed with accompanied posterior malleolar fracture by X‐ray examination before surgery . However ,34 patients were diagnosed with accompanied posterior malleolar fracture by CT three dimensional reconstruction images . Thus , 15 more patients were diagnosed by CT three dimensional reconstruction technique than that by X‐ray imaging .Conclusions:Comparing with X‐ray examination , three dimensional CT reconstruction technique could increase the diagnosis accuracy for posterior malleolar fracture associated with tibia shaft fracture and reduce the rate of missed diagnosis .

Objective:To evaluate the efficacy of anteromedial extensile approach in the treatment of complicated closed pilon fractures classified as type AO/OTA C2 or C3 . Methods:Twenty‐three patients ,who suffered from complicated closed pilon fractures of distal tibia(25 lesions) ,underwent open reduction and internal fixation with anteromedial extensile approach . Among the 23 patients , there were 18 males and 5 females , with mean age of (43 .7 ± 9 .0 ) years . According to AO classification ,there were 11 lesions of type C2 and 14 lesions of type C3 .Operating time ,blood loss ,time of fracture healing , situation of complications ,and American Orthopedic Foot&Ankle Society(AOFAS) score were recorded ,so as to analyze the safety ,the indication ,and the pros and cons of this approach . Results:The average operating time was (119 .6 ± 23 .6)min . The intraoperative blood loss was (168 ± 64 .4) mL .And the time of fracture healing was (12 .5 ± 5 .4)weeks .The AOFAS scores were 81 .9 ± 18 .2 and 79 .9 ± 19 .5 at 12 month and 24 month after surgery ,respectively .Four cases of complications were observed , and there was no patient with invalid internal fixation . Conclusion:During the surgical treatment of complicated closed pilon fractures ,the anteromedial extensile approach allows complete access to the medial and lateral column of distal tibia and the articular surface ,so that the incidence rate of soft tissue complications was low and the clinical efficacy was satisfactory .