Objective To explore the clinical application and efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) treatment of distal tibial fractures.Method From March 2007 to February 2013,MIPPO technology locking compression plate for the treatment of 49 cases of distal tibial fractures,including 12 cases of open fractures,37 cases of closed fractures involving the articular surface 7 cases,38 cases of fracture reduction and limited open reduction of 11 cases.Results Forty-nine patients were followed up for 6-24 months,an average of 12 months,1 case of a finite complex open reduction and nonunion,and re-open reset grafting healing,2 cases of distal tibial fractures delayed healing.The mean healing time was 4.9 months,press the Johner-Wruhs score,excellent in 42 cases,good in 5 cases,and middle in 2 cases.Excellent rate of 95.9％ (47/49).Conclusion MIPPO technology locking compression plate fixation of distal tibial fracture trauma,can reduce the interference of the blood supply of the fracture,fracture healing rate and reduce the rate of infection,is the ideal treatment of distal tibial fractures.

Objective To retrospectively review the experience and early clinical result of carotid endarterectomy (CEA) for the treatment of symptomatic carotid artery stenosis. Method CEA was performed on 82 consecutive patients (66 males, 16 females), age ranged from 48 to 84 years (mean 68.6 years). Diagnosis was established by carotid artery Doppler ultrasonography and DSA in all patients. General anesthesia was used in 39 cases, regional anesthesia was used in 43 cases. Temporary intraluminal shunts were used in 56 patients. Results There was no surgical mortality. Postoperatively 76 patients were followed up from 4 months to 18 months. Symptoms significantly improved in 57 cases, mild improvement was achieved in 14 cases, severe postoperative complication occurred in 3 patients, including cerebral ischemia in 2 cases, intracarotid thrombosis in one. Conclusion CEA is an effective therapy for the treatment of symptomatic carotid artery stenosis.

Objective:To study the clinical effect and safety of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of liver cirrhosis with esophageal variceal bleeding.Methods:86 cases of cirrhotic patients with esophageal and gastric varices bleeding admitted in our hospital from August 2013 to April 2015 were selected and randomly divided into the control group and the observation group with 43 cases in each group.The control group underwent percutaneous transhepatic coronary vein embolization (PTVE) treatment,while the observation group were treated with TIPS.The success rate of surgery,the incidence of various complications,the long-term survival rate and the symptoms and the changes of liver function after operation were compared between the two groups of patients.Results:The portal vein pressure after operation in the observation group was significantly lower than that of the control group (P=0.00),at 3 months,6 months and 12 months after operation,the rebleeding rate in the observation group were significantly lower than that of the control group (P＜0.05),but the incidence of hepatic encephalopathy showed no significant difference between the two groups (P＞0.05);before operation and at 6 months and 12 months after operation,the Child-Pugh score,serum TBIL,DBIL levels showed no significant difference between the two groups (P＞0.05),at 3 months after operation,the Child-Pugh score,serum TBIL,DBIL levels in the observation group were significantly higher than those of the control group (P＜0.01);the 1 year survival rate showed no significant difference between two groups (P=0.72).Conclusion:TIPS could effectively improve the symptoms of varicose veins,better on liver function damage,and enhance the long-term survival high rate with high safely in the treatment of esophageal variceal bleeding in patients with cirrhosis.

This research analyzed the functioning and cost-effect of 93 inpatients with Stroke at post acute Stage using ICF Core Set (Comprehensive Version for Stroke). The main functioning impairments are in ICF categories of b147, b152, b176, b235, b420, b715, s110,s720, s730, s750, d1, d2, d4, and d5. The main improvement of function are in the fields of b1, b4, b7, d1, d2, d4, d5, d6, d7, d8 and d9 (P<0.05). The total expenses of rehabilitation medicine averages 6713.97 RMB. It cost 320.50 RMB to impove 1 score of functioning.

Based on the framework and approaches of International Classification of Functioning, Disability and Health (ICF) and psychometry,the theory and methods of the development and standardization of functioning and disability measurement for stroke were reviewed.

Objective To investigate the key words related with the growth of psychological rehabilitation literature of psychological rehabilitation in China. Methods The journal articles associated with psychological rehabilitation in CNKI were analyzed with key word frequency.The relationship between the cumulative frequency of key words and the growth of literature were analyzed with Linear Regression Analysis. Result Based on the cumulative frequency of 340 key words frequencies more than 4 in each year, Linear Regression Analysis extracted 10 words that correlated with the literature growth, which were Psychological Nursing, Psychological Problem, Psychological Response,Psychotics, Emotional Disorder, Type A Behavior, Social Psychology, SCL-90, Prosthesis, and Psychiatry. Conclusion The major objects of the researches of psychological rehabilitation in China were psychological problem, psychological response, psychotics, emotional disorder, type A behavior; the major tools were social psychology, SCL-90; the researchers mainly come from the nurse, and the professionals of prosthesis and psychiatry.

Objective:To explore the effects and mechanism of anti IL-9 antibody on malignant ascites ( MA) of hepatic carci-noma in mice.Methods:A mouse model of MA was established by mouse H 22 cell line.45 mice were divided randomly into experi-mental group,negative control group and blank control group at 24 hours after modeling,with 15 mice in each group.The experimental group was injected intraperitoneally with anti IL-9 antibody;the negative control group was injected with isotype IgG antibody;the blank control group was injected with normal saline .The weight and behavior of the mice were measured before each injection .Five mice of each group was sacrificed at 24 hours after the last injection to measure the volume of MA .The level of VEGF,MMP-2,IL-9 and IFN-γin MA were determined with ELISA assay;the survival time of rest mice were recorded and compared .Results:The mean volume of MA of experimental group,negative control group and blank control group were (6.70±1.52)ml,(10.28±1.75)ml,(10.36±2.30) ml,respectively,the MA volume of experimental group were lower as compared to negative control group and blank control group ( P<0.05).The mean survival time of experimental group was (17.2±2.1)d,which was significantly prolonged compared with the negative control group (14.5±1.2)d and the blank control group (14.8±1.4)d (P<0.05).The levels of VEGF of MA in experimental group was significantly lower compared to the negative control group and blank control group (P<0.05).The levels of IL-9 of MA in experi-mental group was significantly lower compared to the negative control group (P<0.05).The levels of MMP-2 and IFN-γin experimental group had no significant difference compared with the negative control group and blank control group ( P>0.05 ) .Conclusion:Intraper-itoneal injection anti IL-9 antibody on H22 ascites-bearing mice can effectively inhibit the generation of the MA .The mechanism may be related to the inhibition of the expression of the VEGF and IL-9.

PURPOSETo investigate the changes of cerebral hemodynamics pre- and post-ventricular drainage in patients with posttraumatic acute diffuse brain swelling.

METHODSTwenty-four cases of traumatic diffuse brain swelling were analyzed retrospectively. Patients in nonsurgical group were treated by medicine therapy. Patients in surgical group were treated by external ventricular drainage plus medicine therapy. The first CT perfusion scan was completed within 4-5 h after trauma and scanned again after 7 days. The changes of perfusion parameters in area-of-interest in two groups were analyzed and compared before and after treatment.

RESULTSCompared with the nonsurgical group, the value of cerebral blood volume, cerebral blood flow and mean transit time in bilateral frontal temporoparietal grey matter, basal ganglia, cerebellum, and brain stem at pre- and post-therapy were increased significantly (p < 0.05) in surgical group, and consequently the prognosis of patients undergoing surgery was also better than that of nonsurgical group.

CONCLUSIONExternal ventricular drainage can improve cerebral perfusion and increase survival quality for the patients with posttraumatic acute diffuse brain swelling.

Adult ; Aged ; Brain ; physiopathology ; Brain Edema ; physiopathology ; therapy ; Brain Injuries ; complications ; Cerebrovascular Circulation ; Drainage ; Female ; Hemodynamics ; Humans ; Male ; Middle Aged ; Retrospective Studies

目的人们可能罹患各种疾病并且有不同的健康状况，但是为了充分认识人类生活所处的健康状况，需要有关疾病或健康状况对人类生活影响的综合性信息。本文要探讨健康状况的影响，健康状况可以用国际疾病分类(ICD)术语进行分类，功能概念用国际功能、残疾与健康分类(ICF)术语进行描述。本研究确定了一套ICF的分类类目作为功能属性，与ICD联合应用用于描述普遍的健康状况的影响。方法用于描述任何健康状况下功能属性特征的ICF类目从3个主要的通用健康状况评定工具中选择出来，这三个工具是：世界卫生组织残疾评定量表2.0(WHODAS 2.0)、世界健康调查(WHS)问卷和ICF核心分类集（ICF core sets）通用版类目的一个清单。结果根据特定的功能领域建立了一套描述健康状况影响的ICF类目。结论在ICD-11修订的背景之下，通过一系列的功能属性的ICF类目列表联合运用ICD和ICF可以实现两种分类的有价值的整合，有益于加强患者管理、干预方案的设计和健康结果的报告，能使我们将疾病的严重程度与疾病的影响区别开来。在卫生信息系统应用中， ICD-ICF联合运用建立了一种持续性卫生保健的共享的正式信息表征。

Objective:To evaluate the pedicled bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap for the treatment of soft tissue defects at the contrallateral leg.Methods:Between January of 2012 and January of 2016, 8 patients with soft tissue defects at the leg were treated at Department of Orthopedic Surgery, Hand and Foot Surgery Hospital of Lanzhou. They were 5 men and 3 women, aged from 19 to 50 years (mean, 35 years). All of them were treated by bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap pedicled with posterior tibial artery. The size of the defects ranged from 10 cm×9 cm to 13 cm×8 cm. The immediate coverage of the muscle flaps and vessel pedicle was repaired by a meshed split-thickness skin graft. The donor site was closed directly. The therapeutic efficacy was assessed at the final follow-up according to the criteria by Iowa for tibial fractures.Results:All the skin flaps and muscle flaps survived without any vascular crisis. One case developed necrosis of small skin graft at the distal muscle flap which spontaneously healed after dressing change for 2 weeks. Their follow-up ranged from 2.5 to 4.5 years (mean, 3.8 years). A good contour was confirmed at the recipient area. By the Iowa criteria at the final follow-up, 3 cases were excellent, 4 good and one fair.Conclusion:Pedicled bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap is a good treatment for soft tissue defects at the contrallateral leg which has only one major blood vessel, reducing damage to the donor site.