BACKGROUND:Intramedul ary nail fixation has more advantages in open fractures compared with the locking compression plate, such as the dual functions of lock and compression, highly protecting the blood supply in fracture end, less tissue trauma, firm elastic fixation and low infection rate. OBJECTIVE:To investigate the clinical efficacy and biomechanical properties of tibial intramedul ary nail and locking compression plate in treatment of open tibial fractures by stages. METHODS:Total y 100 patients with open tibial fractures who received treatment at the Department of Orthopedics, Jiaozhou Central Hospital of Qingdao Affiliated to Weifang Medical Col ege from January 2012 to January 2014 were enrol ed. Patients were divided into tibial intramedul ary nail group (n=57) and locking compression plate group (n=43) according to the surgical procedures using randomized control ed method. Ten corpses models of open tibial fractures provided by Jiaozhou Central Hospital of Qingdao Affiliated to Weifang Medical Col ege were selected, and then randomly divided into 2 groups. Three-point bending test, axial compression test and torsional strength test were conducted after the fixation with tibial intramedul ary nail and locking compression plate. RESULTS AND CONCLUSION:The operative time and per-operative blood loss of patients in the tibial intramedul ary nail group was significantly less than those in the locking compression plate group (P<0.05). There were no significant differences in wound infection, fixtures loosening, not healing and other complications after fixation between these two groups. There were no incision infection in these two groups. The specimens bending test offset, axial compression experiments offset and torsion test torsion angle in tibial intramedul ary nail group were significantly less than those in the locking compression plate group (P<0.05). These results demonstrate that tibial intramedul ary nail and locking compression plate for treatment of open tibial fractures by stages can achieve the desired therapeutic effect, however, the biomechanics of tibial intramedul ary nail is more stable, and more in line with the biomechanical properties of human body, with the advantages of firm fixation, doing exercises in early stage and smal stress shielding. Choosing the appropriate materials according to patient’s symptoms and fracture location during treatment can improve the curative effect.

To identify the cause of an outbreak of acute hemorrhagic conjunctivitis (AHC) in Jiangxi (China) in 2010, 20 eye conjunctival swabs were first collected from AHC patients. Then, viruses were isola- ted and tested for human enterovirus 70, coxsackievirus A24 variant (CV-A24v) and adenovirus using the polymerase chain reaction. All CV-A24v isolates underwent sequencing of 3C and VP1 coding regions. Then, a phylogenetic tree was constructed for Jiangxi CV-A24v and worldwide CV-A24v based on,3C and VP1 regions, respectively. Ten out of 20 specimens were positive for CV-A24v, implying that the outbreak was caused by CV-A24v. The phylogenetic tree based on the 3C region showed that Jiangxi CV- A24v belonged to cluster 5 in genotype IV (GIV-C5) with strains isolated throughout the world after 2010, and were divided further into A and B lineages. Phylogenetic analyses of the VP1 region showed that all of the worldwide CV-A24v strains isolated after 2000 could be divided into five groups (1-5). Jiangxi CV-A24v was classified into group 5 and also divided further into A and B lineages upon analyses of the 3C region. These data suggested that CV-A24v causing AHC outbreaks in China in 2010 belonged to GIV-C3 and GIV-C5. At least two transmission lineages were circulated in Jiangxi in 2010. The classification of CV-A24v isolated after 2010 worldwide using the phylogenetic tree based on the VP1 region was almost consistent with that based on the 3C region and also had significant chronological clustering.
China ; epidemiology ; Conjunctivitis, Acute Hemorrhagic ; epidemiology ; virology ; Coxsackievirus Infections ; epidemiology ; virology ; Disease Outbreaks ; Enterovirus C, Human ; classification ; genetics ; isolation & purification ; Genotype ; Humans ; Molecular Sequence Data ; Phylogeny ; Viral Proteins ; genetics

OBJECTIVE: To review the studies about the tibial-graft fixation methods on anterior cruciate ligament (ACL) reconstruction, in order to provide clinical reference. METHODS: The literature about the tibial-graft fixation methods on ACL reconstruction at home and abroad was extensively reviewed, and the factors that affect the selection of fixation methods were summarized. RESULTS: The knee flexion angle, graft tension, and graft fixation device are mainly considered when the tibial-graft was fixed on ACL reconstruction. At present, the graft is mainly fixed at 0°/30° of knee flexion. The study shows that the knee joint is more stable after fixed at 30°, while the incidence of knee extension limitation decrease after fixed at 0°. In terms of graft tension, a good effectiveness can be obtained when the tension level is close to 90 N or the knee flexion is 30° to recover the affected knee over-restrained 2 mm relative to the healthy knee. In terms of the graft device, the interference screw is still the most commonly used method of tibial-graft fixation, with the development of all-inside ACL reconstruction in recent years, the cortical button fixation may become the mainstream. CONCLUSION Arthroscopic reconstruction is the main treatment of ACL rupture at present. However, there is no optimal fixation method for the tibial-graft, the advantages and disadvantages of each fixation methods need to be further studied.
Humans ; Tibia/surgery* ; Anterior Cruciate Ligament Reconstruction ; Knee Joint/surgery* ; Anterior Cruciate Ligament Injuries/surgery* ; Bone Screws