OBJECTIVETo retrospective analysis the complications after treatment of metacarpal and phalangeal fractures with internal fixation, and propose measures to prevent or reduce surgical complications.

METHODSFrom July 2007 to October 2009, 342 patients with metacarpal and phalangeal fractures were treated with internal fixation,including 203 males and 139 females with an average age of 30.4 years old ranging from 18 to 56 years. There were 217 right hands and 125 left hands, 38 cases of the first metacarpal fracture, 47 cases of the second metacarpal fracture, 52 cases of the third metacarpal fracture, 40 cases of the forth metacarpal fracture, 39 cases of the fifth metacarpal fracture, 43 cases of the proximal phalangeal fractures, 52 cases of the middle phalangeal fractures, and 48 case of the distal phalangeal fractures. The fractures were fixed with K-wires in 129 patients, mini plates in 153 cases, screws in 48 cases, wires in 12 cases.

RESULTSAll 324 patients were followed up for 3 to 15 months (averaged 8.5 months) and complications occurred in 74 patients (22.84%). The main complication was unhealthy wound healing in 24 patients (7.4%), others was adhesion of tendon in 54 patients (16.67%), malunion in 34 patients (10.49%), nonunion in 13 patients (4.01%) and shortening of metacarpal and phalangeal in 21 patients (7.41%).

CONCLUSIONThe important reasons responsible for complications are iatrogenic factors such as unsuitable implant selection, unskillful surgical technique and improper post-operative functional rehabilitation.

Adolescent ; Adult ; Female ; Finger Phalanges ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Follow-Up Studies ; Fracture Fixation, Internal ; adverse effects ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Metacarpal Bones ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Middle Aged ; Postoperative Complications ; prevention & control ; Recovery of Function ; Tomography, X-Ray Computed ; Young Adult

Objective To investigate the status of infection and distribution of rabies virus (RV) in different epidemic areas in China. Methods Brain specimens from animals and suspected patients were collected at the districts of high-, medium- and low incidence rates of human rabies and detected by both direct Immunofluorescence assay (DFA) and RT-PCR. Results 254 of 3007 specimens of dog brains showed RV positive by DFA (positive rate of 8.4% ). Among these 254 samples, 78 showed positive (positive rate of 30.7% ) by RT-PCR. 93 specimens from dogs and cats that had attacked human beings, 63 of them showed positive by DFA (positive rate of 67.7%) and all of them were also positive by RT-PCR. In addition, RV could also be detected in Apodemus agrarius,ferret badger, and suspected patients specimens from the districts under survey. There was no statistical difference between the infection rates of RV in different provinces and regions with different incidence of rabies. Conclusion There might be a relatively high infection rate of RV among the domestic dogs/cats in the endemic areas in China. Wild animals might have been infected with RV in the districts under survey.

Objective:To understand the swallowing function of the elderly in welfare homes of Wenzhou City，Zhejiang Province and to analyze the related factors of swallowing dysfunction. Methods:A total of 507 elderly people aged 60 years and over were surveyed by questionnaires in three welfare homes of Wenzhou City from January 2018 to January 2020.Hinds time-limited water drinking test was used to screen dysphagia. Multivariate unconditional logistic regression analysis was used to analyze the related factors of swallowing dysfunction. Results:The incidence of swallowing dysfunction was 26.04% （132 out of 507）. Univariate analysis showed that there were significant differences in the incidence of swallowing dysfunction among the elderly in terms of age， spouse condition， self-care ability， health status， taking sleeping pills， cerebrovascular disease， nervous system disease and depression （P<0.05）. Multivariate logistic regression analysis showed that the following factors were related to swallowing dysfunction among the elderly： age ≥80 years old， taking sleeping pills， cerebrovascular diseases， nervous system diseases and depression. Conclusion:The incidence of swallowing dysfunction in elderly people in welfare homes of Wenzhou City is high， especially those aged ≥80 years who need more attention. In addition， taking sleeping pills， cerebrovascular diseases， nervous system diseases and depression all increase the risk of swallowing dysfunction. Corresponding preventive and intervention measures should be formulated.