Objective To evaluate the clinical significance of anatomic reduction and internal fixation of posterior malleolar fracture in ankle fracture surgical treatment. Methods Fifty-four patients with posterior malleolar fracture were treated with anatomic reduction and internal fixation from March 2005 to June 2010. The patients groups consisted of 36 males and 18 females. According to CT scan classification,the group was made up of 36 type Ⅰ cases, 10 type Ⅱ and 8 type Ⅲ cases. All patients were evaluated with modified Baird-Jackson scoring system. The relationship between final result and fracture pattern , fixation methods, the time of exercise initiation fitted operation were analyzed respectively. Results The followedup period varied from 6 months to 36 months, with an average of 18 months. The number of patients whose result was excellent, good, fair and poor was respective 29,18 ,5 and 2. The total percent age of good to excellent clinical result was 87. 03%. There were 4 patients who had only slight pain after long time walking ,the remainder patients were completed with no pain. Conclusion Operative treatment may provide satisfactory fracture anatomic reduction and internal fixation for posterior malleolar fracture. Correct fracture pattern estimation and proper internal fixation are important to achieve and improve reduction quality, and to ameliorate better long term results.

Objective To investigate the criteria for assessing the clinical therapeutic effect of chronic urticaria in China.Methods The application of criteria for assessing the clinical therapeutic effect of chronic urticaria in China and their applicable scope were analyzed by frequency analysis and K-means clustering analysis, respectively.Results The criteria for assessing symptoms and therapeutic effect were different in the 857 papers included in this study. SSRI was used in 549 (64.17) out of the 857 papers included in this study.K-means clustering analysis showed that the applicable scope of SSRI with curative rate ( 100%≥SSRI>90%) , improvement rate ( 90%≥SSR<60%) , Significant effect rate (60%≥SSRI>20%) , and no response rate (20%≥SSR≥0%) as its criteria was wider than that of frequency analysis.Conclusion The criteria for the clinical assessment of chronic urticaria and its drug treatment effect should be unified and standardized.

Objective: To study the effect of color Doppler ultrasound (CDUS) combined with serum glucoside antigen 125 (CA125) on the diagnostic efficacy of patients with ovarian cancer. Methods: A total of 78 patients with ovarian tumors admitted to our hospital from February 2012 to June 2018 were enrolled. Among them, 38 patients with malignant tumors and 40 patients with benign tumors were tested for CDUS and serum CA125. The characteristics of CDUS images and serum CA125 levels in patients with malignant tumors were analyzed by pathological examination as the gold standard. The diagnostic efficacy of CDUS combined with serum CA125 level detection and separate examination was analyzed. Results: ⑴ Characteristics of CDUS images: the size, location, texture, blood flow signal, resistance index, ascites, peritoneal implant nodule or enlarged lymph node of patients with malignant tumors were significantly different from those of benign tumors (P<0.05). ⑵ Serum CA125 level: the serum CA125 level of patients with malignant tumors was higher than that of patients with benign tumors (P<0.05). ⑶ Diagnostic results: among 78 patients with ovarian tumors, 33 cases of malignant tumors were detected by serum CA125, 45 cases of benign tumors, of which 5 cases were misdiagnosed, and 10 cases were missed. For example, CDUS detected 35 malignant tumors and 43 benign tumors, of which 6 were misdiagnosed and 9 were missed. A total of 43 malignant tumors and 35 benign tumors were detected, of which 6 were misdiagnosed and 1 was missed. ⑷ Diagnostic efficacy: the accuracy of CDUS combined with serum CA125 level detection (91.03%) was higher than that of the two groups (80.77% and 80.77%), but the difference was not statistically significant (P>0.05); the sensitivity of CDUS combined with serum CA125 level detection was 97.37%. The two were independently examined by 76.32% and 73.68% (P<0.05). The specificity of CDUS combined with serum CA125 was 85.00%, with no significant difference between the two groups (80.05%, 87.50%) (P>0.05). Conclusions The serum CA125 level of patients with ovarian cancer is abnormally elevated. The characteristics of CDUS images are different from those of benign tumors, which can effectively identify benign and malignant tumors. CDUS combined with serum CA125 level detection can significantly improve the diagnostic efficacy, and they can be used to judge the disease and symptom , and provide guidance for treatment and prognosis assessment.

Objective To investigate the echocardiographic features of fetal Ebstein's anomaly (EA) and to analyze its clinical outcome and prognosis.Methods A retrospective case-control study was conducted to analyze the echocardiographic features in fetus with EA.Thirty-five EA fetuses (EA group) and 35 normal fetuses matched for gestational age (control group) were enrolled.The main echocardiographic parameters of the two groups were collected and compared.According to the direction of blood flow in the ductus arteriosus (DA),fetuses in EA group were divided into DA reverse perfusion subgroup (n=11) and normal DA blood flow subgroup (n=24).The echocardiographic parameters and GOSE scores were compared between the two subgroups.The echocardiographic features of EA and the difference of fetal hemodynamics were summarized,and the clinical outcome of EA fetus was evaluated by GOSE score.Chi-square test Rank sum test or t test were used for comparison between groups.Results Nineteen (54％) of the 35 patients terminated the pregnancy and 16 (46％) continued pregnancy until delivery during follow-up.Compared with the normal fetus group,the cardiothoracic ratio was significantly higher (0.47±0.11 vs.0.34±0.01,t=6.640,P＜ 0.01) and the transverse diameter ratio of right atrium to left atrium was significantly greater (1.42±0.38 vs.1.08±0.11,t=5.030,P＜0.01) in the EA group,and the ratio of pulmonary artery diameter to aortic diameter was significantly lower in the EA group (1.04±0.21 vs.1.20±0.15,t=-3.770,P ＜ 0.01).Compared with the normal DA blood flow subgroup,the GOSE scores ≥ 1.5 was more frequently seen (7/11 vs.3/24,P=O.004) and the ratio of pulmonary artery diameter to aortic diameter was significantly lower (0.91 ± 0.18 vs.1.24 ± 0.20,t=-4.696,P=-0.002) in the DA reverse perfusion subgroup.Six of the 16 delivery cases underwent EA corrective surgery after birth with 100％ successful rate of operation.Among the 6 cases,two had preoperative GOSE score of ≥1.5 who were considered as severe cases,and four had low GOSE score of＜1.5.The remaining ten cases who had not undergone the corrective surgery were followed up routinely.Conclusion Prenatal hemodynamics of EA combined with GOSE score can more accurately evaluate the severity and prognosis of fetal EA,reduce unnecessary labor induction,and improve postpartum cure rate and clinical outcomes.