Objective To evaluate the clinical result of anterior elbow approach and internal fixation for the treatment of capitulum humeri fractures. Methods From January 1997 to December 2003,11 patients of 9 males and 2 females with capitulum humeri fractures were chosen anterorredial approaches of elbow. The fractures were terated with under direct vision and were fixed with screws. The left arms in 7, right in 4, the age of the group were from 14 to 18 years old, with the average of 15 years. 7 cases of them were treated with close reduction but failed. The operative time was from 3 days to 7 days after injury. They were fresh and close fractures. According to wangyicong's classification system all were TypeⅠ. Results All operations were successful, no nerves and blood vessels injury, the incisions were all healed by first intention. The X-ray films shows that the fractures were anatomic reduction. The healing time was 6 weeks in average and all patients were followed up with an average 3.5 years, no postoperative complications such as:myositis ossificans, post-traumatic arthritis, avascular necrosis of capitulum humeri. According to Cassebanm and the percentage of elbow joints pain was measured with patient visual pain index function score system: 7 caese of excellent, 4 case of good. Conclusion Displace of capitulum-trochlea hemeri does not link with muscle and capsula articularis, blood carries supply. Without avascular necrosis probably occurs at far stage. The close manipulation of capitulum humeri fractures hardly succeeds. The treatment with accurate open reduction associated with strong fixation can decrease the rate of avascular necrosis in the capitulum humeri fractures. The capitulum humeri fractures are suitable for opening reduced direct vision and fixing with screws through anteroeedial approaches of the elbow. The patients were encouraged to proceed for active rehabilitation early such as the elbow flexion-extension. Its short-term clinical outcomes is more excellent.

Objective: To observe the value of preoperative enhanced MSCT before interventional treatment of iatrogenic hemorrhage in different positions of urinary system. Methods: Data of 27 patients underwent interventional therapy for iatrogenic bleeding in different positions of the urinary system were retrospectively analyzed. The detection rate of bleeding responsible vessels were compared between preoperative enhanced MSCT and the first time intraoperative DSA. CT and DSA findings were also studied. Results: Bleeding responsible vessels were identified in 26 patients (26/27, 96.30%) with preoperative enhanced MSCT, mainly manifested as arterial plaque contrast agent extravasation, contrast agent concentration and early developing of renal vein. Sign of arteriovenous fistula detected with the first time intraoperative DSA was observed in 1 patient without a clearly responsible vessel for bleeding using preoperative enhanced MSCT. In 24 patients (24/27, 88.89%), the responsible vessels for bleeding were identified with the first time intraoperative DSA, mainly manifested as contrast agent extravasation, pseudoaneurysm and renal arteriovenous fistula. Responsible vessels for bleeding were not detected with the first time intraoperative DSA in 3 patients who had characteristic findings of preoperative enhanced MSCT, including contrast agent extravasation in 2 patients and early developing of renal vein in 1 patient. With the reference of preoperative MSCT manifestations, bleeding responsible vessels were clearly detected with the second time DSA during operation. There was no significant difference of the detection rate of bleeding responsible vessel between preoperative enhanced MSCT and the first time intraoperative DSA (χ2=1.08, P=0.29). Conclusion: Bleeding responsible vessels of iatrogenic hemorrhage in different positions of urinary system can be detected accurately with preoperative enhanced MSCT. Enhanced MSCT images can also be used as the references for patients without clearly responsible vessel for bleeding using the first time intraoperative DSA of interventional therapy, so as to embolize the responsible vessel rapidly and effectively.

Objective To explore the influence of individualized health education to asthma children on the quality of life of their parents.Methods One hundred and one parents of asthmatic children from 3 different communities were randomly assigned to the intervention group(n=52)and the control group(n=49).Follow-ups were performed by phone calls and the Children Asthma Health Education Brochures were distributed among them in the two groups,meanwhile the individualized health education was given to the intervention group.The paediatric asthma caregiver's quality of life questionnaire(PACQLQ)was used to assess the quality of life of two groups.Results One month after intervention,the scores of the intervention group on PACQLQ total score as well as its items of activity limitation and emotional function were significantly higher than the control group(P<0.001 for all).Conclusion The individualized health education to the asthmatic children can improve the quality of life of their parents.

Objective To observe the effect of ultrasound-guided transversus abdominis plane block combined with diclofenac sodium suppository in anus on postoperative analgesia and early recov-ery after laparoscopic hysterectomy.Methods Sixty-six patients of laparoscopic hysterectomy,aged 40-60 years,were randomly divided into group T and group D,33 cases in each group.Group T used ultrasound-guided bilateral transversus abdominis plane (TAP)block after surgery.Group D used TAP block and diclofenac sodium suppositories in anus.All patients received PCIA.Postoperative 24 h sufentanil dosage out of analgesia pump and the effective press times were recorded.The incidence of dysphoria,nausea and vomit within postoperative 24 h,the time of first out-of-bed activity,the time of first anal exhaust and the time of removing urine tube were measured.The plasma concentra-tion of interleukin-6(IL-6),C reactive protein (CRP)and cortisol (Cor)were recorded at the follow-ing four time points:before anesthesia,just postoperative moment,8 and 12 h after surgery. Results Compared with group T,the sufentanil dosage [(18.6±3.2)μg vs (40.8±5.1)μg]and the effective press times [(9.3±2.2)times vs (20.4±3.5)times]were fewer in group D (P<0.05).The incidence of dysphoria,and nausea and vomit were less in group D compared with group T (P<0.05).The IL-6,CRP and Cor of group D at 12 h were lower than those of group T (P<0.05). But the times of first out-of-bed activity,anal exhaust and removing urine tube in two groups were not significantly different.Conclusion Transversus abdominis plane block combined with diclofenac sodium suppositories in anus can provide safe and effective postoperative analgesia for laparoscopic hysterectomy,and promote the early fast recovery.

Objective To evaluate the efficacy and safety of prostatic arterial embolization (PAE) and transurethral resection of prostate (TURP) in treatment of benign prostatic hyperplasia (BPH).Methods Totally 40 patients with BPH from Jan 2016 to Oct 2016 were selected.All patients were divided into PAE (n=20) and TURP (n=20) group by random number table method.The curative effect indexes (international prostate symptom score [IPSS],quality of life score [QOL],prostate volume [PV],postvoid residual [PVR],maximum urinary flow rate [Qmax] and prostate-specific antigen [PSA]),the complications and side effects,as well as the incidence of sexual dysfunction were analyzed and compared between the two groups.Results No statistical difference of IPSS,QOL,PV,PVR,Qmax nor PSA was found between the two groups before operation (all P＞0.05).IPSS,QOL,PV,PVR and PSA were significantly lower than those before operation 3,6 and 12 months after operation (all P＜0.05),while Qmax was obviously higher than that before operation (P＜0.05).Three months after operation,the curative effect indexes were statistically different between the two groups (all P＜0.05),while no statistical difference was found 6 and 12 months after operation (P＞0.05).The incidence of postoperative complications in TURP group was higher than that in PAE group (x2 =4.329,P=0.037).There was no statistical difference in the incidence of sexual dysfunction between the two groups (x2=2.105,P=0.147).Conclusion PAE and TURP can significantly alleviate clinical symptoms of patients with BPH.Three months after operation,the efficacy of TURP is better than PAE,but PAE is more minimally invasive and has fewer complications.

Objective To explore the application of the infusion management system in ICU and its effect on the major nursing risk factors .Methods One hundred and five patients with top ten diseases in ICU from March 2013 to December 2013 were chosen and were randomly divided into the control group ( n=50 ) and the observation group ( n =55 ) .The control group received the management of liquid therapy through the monomer infusion pump , and the observation group received the management of liquid therapy through B .Braun infusion therapy system .The average time of liquid therapy , the rate of unplanned extubation , the error rate of vasoactive drugs and the nurses ’ satisfaction of two groups were observed .Results The average time of liquid therapy, the rate of unplanned extubation , the error rate of vasoactive drugs and the nurses ’ satisfaction were respectively (65.3 ±21.4)h, 7.3%, 7.3%, 92.7%in the observation group, and were better than (99.4 ± 27.8)h, 16.0%, 14.0%, 56.0% in the control group, and the differences were statistically significant (t/χ2 =2.63, 7.25, 5.38, 8.68, respectively;P<0.05).Conclusions Application of B.Braun infusion therapy system in ICU can reduce the workload of nurses , and decrease the rate of unplanned extubation and the error rate of vasoactive drugs in patients , and increase the nurses ’ satisfaction.

Objective:To observe the pronunciation of consonants among children with developmental speech sound disorder and explore the correlation between mispronounced consonants and short-term memory so as to determine the pathogenesis of the disorder.Methods:Thirty-six children with developmental speech sound disorder and aged 4 to 13 years were evaluated. Their pronunciation of consonants at the phoneme and lexical levels was tested to record the error types and error rate. Twelve of the children were then randomly chosen to form a voice disorder group. Another 10 healthy counterparts constituted a control group. The short-term memory of both groups was assessed and any correlation between pronunciation and short-term memory was analyzed.Results:The children with a developmental speech sound disorder differed significantly from the controls in terms of the numbers of errors in articulating blade-alveolar, blade-palatal and velar consonants. On the phoneme level, the highest substitution error rate occurred when pronouncing lingua-palatal consonants (42.86%), followed by supradental consonants (32%). The highest distortion and non-acquisition error rates were with blade-palatal consonants (14%) and lingua-palatal consonants (9.5%). On the vocabulary level, the highest substitution, distortion, ellipsis and non-acquisition error rates appeared when pronouncing lingua-palatal and velar consonants, velar and blade-palatal consonants, supradental consonants as well as blade-palatal consonants. Significant differences were found between the phoneme and lexical levels in the substitution of supradental and blade-palatal consonants as well as in the ellipsis of blade-alveolar consonants. They were moderately associated with pronunciation level. There was, however, no significant difference in working memory span between the two groups, and no significant correlation was observed between working memory span and pronunciation level.Conclusion:The mispronunciation of consonants by children with developmental speech disorders is higher at the lexical than at the phoneme level. They mainly substitute lingua-palatal and velar consonants and elide supradental consonants, which may be related to short-term memory span.