Objective To explore the application of rapid rehabilitation concept in perioperative period of colorectal cancer.Methods A total of 110 patients with rectal cancer admitted in our hospital from June 2012 to July 2015 were enrolled in the research group(55 cases)and control group(55 cases).The observation group was treated with rapid rehabilitation method,and the control group was treated by traditional perioperative method.Observation of the two groups of patients was in the hands of the amount of bleeding,operation time,the first time the patient exhaust time,postoperative time to get out of bed and other indicators.We observed the two groups of patients with surgical incision infection,intestinal obstruction,pulmonary infection and other complications.Results The difference of the amount of bleeding and the length of the incision in the two groups was statistically significant(t=9.618,7.846,P<0.01).The first time of exhaustive time,the first defecation time,the time of eating,the time of getting out of bed and the postoperative hospital stay of research group were significantly lower than those of the control group(P<0.01).The incidence of complications such as incision infection,intestinal obstruction and pulmonary infection of the research group was lower than those in the control group,and the difference was statistically significant(χ2=4.767,P<0.05).Conclusion The application of rapid recovery concept in perioperative period of colorectal cancer can reduce the incidence of surgical complications.

Objective To investigate the effectiveness and safety of fast-track surgery (FTS) application in gastric cancer operation.Methods A total of 196 cases of gastric cancer operation in our hospital from January 2012 to June 2016 were selected and divided into the FTS group and tradition group,98 cases in each group.The postoperative first time exhaust and defecation time,hospitalization stay length,hospital costs and postoperative complications were compared between the two groups.Results The postoperative first time exhaust and defecation time in the FTS group were earlier than those in the tradition group,the hospitalization duration was decreased and hospitalization costs were reduced,the differences between the two groups were statistically significant(P＜0.05).The occurrence rate of pulmonary complications had statistically significant difference between the two groups(P＜0.05).Digestive tract fistula,fatality rate,re-hosplitalization rate and occurrence rate of overall complications had no statistical difference between the two groups(P＞0.05).Conclusion The application of FTS in gastric cancer operation can promote more rapid recovery of gastrointestinal function,shortens hospitalization stay and reduces the hospitalization costs.

Objective:To discuss the surgical strategies for anteromedial tibial plateau compression fracture complicated with posterolateral corner injury.Methods:From 2015 January to 2020 July, 18 patients with anteromedial tibial plateau compression fracture complicated with posterolateral corner injury were admitted to Department Ⅲ of Orthopaedics, Zhongshan Hospital of Traditional Chinese Medicine. They were 11 males and 7 females, aged from 28 to 57 years (average, 38.6 years). By the CT three-column theory, all their fractures were medial column ones; by the Fanelli classification, there were 5 cases of type B and 13 cases of type C. Seventeen patients with fresh fracture were treated with arthroscopic ligament reconstruction and meniscus repair followed by primary reduction and fixation of tibial plateau fracture. The one patient with obsolete injury was treated with high tibial osteotomy around the knee joint and reconstruction of the anterior cruciate ligament. Recorded were the patients' fracture healing time, knee Lysholm score, joint range of motion and complications.Results:The 17 patients with fresh injuries were followed up for 12 to 24 months (average, 18.4 months). Their fracture healing time ranged from 12 to 24 weeks (average, 17.7 weeks). By one year after surgery, their knee extension reached 0° and their knee flexion from 120° to 135° (average, 131.9°); their knee Lysholm scores ranged from 88 to 95 points (average, 91.2 points). The one patient with old injuries was followed up for 18 months, with fracture healing time of 18 weeks, knee range of motion from 0° to 120° and knee Lysholm score of 86 points by one year after operation. None of the patients reported such complications as neurovascular injury, wound infection, internal fixation failure or nonunion.Conclusion:For anteromedial tibial plateau compression fracture complicated with posterolateral corner injury, primary repair and reconstruction can restore knee joint stability, leading to fine therapeutic outcomes.

BACKGROUND:After the internal fixation of cannulated screws in femoral neck fractures,because the affected limb is often unable to bear weight in the short term and the implants with high stiffness have a stress shielding effect on the fracture end,it is easy to cause osteoporosis of the affected limb and changes in the biomechanical distribution of the proximal femur,the incidence of osteonecrosis of the femoral head is high after surgery.At present,few studies have been conducted on the biomechanical effects of osteoporosis at the proximal end of the femur occurring after femoral neck fracture surgery on femoral neck fracture treated with cannulated screws. OBJECTIVE:Using finite element analysis,to investigate the biomechanical effects of osteoporosis occurring after femoral neck fracture surgery on femoral neck fracture treated with cannulated screws and explore the role of biomechanical factors in osteonecrosis of the femoral head. METHODS:Based on the obtained CT scan data of the femur in a patient with a femoral neck fracture,a proximal femoral model for internal fixation for femoral neck fracture was established by Mimics 19.0,3-Matic,UG 11.0,Hypermesh 14.0,and Abaqus software.One finite element model of the proximal femur without osteoporosis and three finite element models of the proximal femur with osteoporosis were analyzed using Abaqus software.The stress,contact pressure,displacement peak and cloud map under different components of the four models were measured and analyzed,and the internal stress changes and distribution of the femoral head were compared and analyzed. RESULTS AND CONCLUSION:The stresses and contact pressures of the femoral head and lower anterior cannulated screws varied more with the degree of osteoporosis.The peak displacement of the four models increased slowly with the degree of osteoporosis.By one-way analysis of variance,there was no significant effect of the degree of osteoporosis on the peak stress,contact pressure,and displacement of the different components.The internal stress distribution of the femoral head changed with the degree of osteoporosis.Changes in the biomechanical environment of the proximal femur have an important impact on osteonecrosis of the femoral head.