Objective To investigate the operative treatment of Sanders' type Ⅲ displaced intra-articular fractures of the calcaneus using a small dorsolateral incision.Methods From October 2006 to April 2012,90 patients with displaced intra-articular calcaneal fracture of sanders' type Ⅲ were treated by open reduction and internal fixation through a small dorsolateral incision at our department.The skin incision was made from the distal tip of the fibula to the base of the fourth metatarsal.They were 69 men and 21 women,aged from 17 to 61 years (average,39 years).On the right side were 49 cases and on the left side 41 cases.According to Sander's classification,26 fractures were of type Ⅲ AB,36 of type Ⅲ AC and 28 type Ⅲ BC.The displacements of articular facet were all larger than 1 mm.The foot functions were evaluated before and after operation by the American Orthopedic Foot and Ankle Society (AOFAS) scoring system.Results For each patient,4 to 6 calcaneal cannulated screws of 4.0 mm and 2 full threaded screws of 6.5 mm were used.No incision infection,skin necrosis or injury to the posterior tibial nerve or vessels occurred after surgery.Seventy-six patients were followed up for 10 to 56 months (average,20.5 months).Clinical union was achieved after 8 to 12 weeks (average,9.5 weeks).The lateral and axial X-ray films of the calcaneus at the last follow-up showed fine reduction and fixation of the fracture fragments and significant improvements in the length,width,height,and B(o)hler and Gissane angles of the calcaneus compared with the preoperation (P ＜ O.05).The ankle and hindfoot scored 70 to 100 AOFAS points at the last follow-up.Forty-five cases were excellent,24 good,5 fair and 2 poor (excellent to good rate of 90.8％).Follow-up observed no infection,nonunion or osteomyelitis.Conclusion Open reduction and internal fixation through a small dorsolateral incision is a good option for Sanders' type Ⅲ calcaneus fractures with a displacement of more than 1 mm,because it leads to minimal soft tissue damage,excellent exposure and convenience for later removal of internal fixators and subtalar arthrodesis.

Objective To observe the relationship between short-term heart rate variability(HRV) and heart rate recovery (HRR) after exercise.Methods 495 patients (273 men),whose age ranged 19-85 years,were submitted to treadmill exercise tests and short-term HRV evaluations.The standard deviation of the normal-to-normal interval (SDNN),the square root of the mean squared differences of successive normal-to-normal intervals (RMSSD),the number of interval differences of successive normal-to-normal intervals greater than 50 ms (NN50 count),the proportion derived by dividing NN50 count by the total number of normal-to-normal intervals (pNN50) and frequency(lowfrequency power,high-frequency power,total power) domains were observed.Results Among 495 patients,106 patients(68 men) were elderly(age≥65 years).Male gender and hypertension were significantly higher in elderly patients.The young patients had higher HRR after exercise.HRR at 4min (54 ± 13) vs (60 ± 12) beats/min,P =0.003 was the most significant predictor for positive exercise test result.In the young group,both time domain measures (SDNN:correlation coefficient 0.34,P ＜ 0.001 ; RMSSD:correlation coefficient 0.37,P ＜ 0.001) and frequency domain measures (LF:correlation coefficient 0.21,P ＜ 0.001 ; HF:correlation coefficient 0.13,P =0.01 ; total power:correlation coefficient 0.22,P ＜ 0.001) were significantly associated with HRR at 4min.Conclusion HRR at 4min was significantly associated with short-term HRV of time and frequency domains in young individuals,but not elderly ones,who received treadmill exercise test.

Objective To explore the value of Sysmex UF-1000i urinary sediment analyzer in diagnosis of urinary tract infection (UTI) and clarify the influence caused by different specimen on UF-1000i diagnosing UTI.Methods Totally 466 specimens examined bacterial culture and routine urinalysis were collected from patients suspected of UTI during July and August,2015 (samples of group A).148 specimens during late March and early April were gathered to implement a urine culture and then the rest of urine were detected byUF -1000i urinary sediment analyzer instantly(samples of group B).Bacteria and leukocyte counts were gathered and then receiver operating characteristic (ROC) carve was drawn regarding thegold standard as bacterial culture by SPSS18.0.Next,the threshold values of bacteria and leukocyte counts for diagnosis of UTI were found out.Meanwhile,itssensitivity,specificity,positive/negative predictive value,false positive/false negative value,and diagnostic accuracy were calculated.Results The cut off values to samples of group A were101.7 bacteria/μl and 18.8WBC/μl respectively and to samples of group B were 98.7 bacteria/μl and 11.1WBC/μl respectively.The area of Bacteria and leukocyte counts under ROC carve was 0.604 and 0.661 to samples of group A and 0.941 and 0.848 to samples Of group B.To samples of group B,combined Bacteria and leukocyte counts for UTI,the optimum sensitivity was 82.4％,specificity was 92.1％,positive predictive value was 77.8％,negative predictive value was 93.8％,false positive rate was 7.9％,false negative rate was 17.6％,and accuracy was 89.9％.Bacterial culture was reduced by 70.9％.Conclusion UF-1000i urine sediment analyzers have the value of early screening value and help to diagnose UTI.Urine that was sterilely collected and examined within two hours can make the value of UF-1000i maximized.

【Objective】 To investigate the effect of AIDET communication mode in informing blood donors of reactive viral markers results. 【Methods】 Blood donors who came FOR COUNSELLING AFTER NOTIFICATION OF THEIR REACTIVE SCREENING TEST RESULTS from Jan 2018 to Sep 2021 were selected as the subjects. They were divided into two groups according to the blood donation time and notification mode: control group who were notified by a conventional mode(n=128), from Jan 2018 to Dec 2019, and the experimental group(n=92) who were notified by AIDET mode, from Jan 2020 to Sep 2021. The anxiety state and degree of satisfaction to the notification were compared between the two groups. 【Results】 After attending COUNSELLING, the anxiety level of the experimental group was significantly lower, while the degree of satisfaction to the notification was significantly higher than that of the control group (P<0.05). 【Conclusion】 AIDET communication mode established a standardized and effective communication channel and reduced the anxiety of blood donors WHEN NOTIFYING THE REACTIVE SCREENING TEST RESULTS. Moreover, it can enhance the trust and satisfaction between donors and medical staff as well as the quality of notification, which is of great significance to promote the healthy and continuous development of voluntary blood donation.

Objective To compare the efficacy of laryngeal tube suction Ⅱ (LTS Ⅱ ) and ProSeal laryngeal mask airway (PLMA) for airway management during general anesthesia. Methods One hundred and twenty adult ASA Ⅰ or Ⅱ female patients, aged 30-50, with body mass index ＜ 30 kg/m2, undergoing general anesthesia for elective surgery were randomly divided into 2 groups ( n = 60 each) : PLMA group and LTS Ⅱ group. Each group was further divided into 2 subgroups: PLMA controlled ventilation group (group PC), PLMA spontaneous breathing group (group PS), LTS Ⅱ controlled ventilation group (group LC) and LTS Ⅱ spontaneous breathing group (group LS) . The rate of successful insertion was recorded. PetCO2 , peak airway pressure, lung compliance and incidence of gas leakage during controlled ventilation were recorded before operation, 10 min after the start of operation and at the end of operation. The tidal volume and PetCO2 were recorded in patients breathing spontaneously when the breathing was stable. The bucking and body movement were observed during removal of LTS Ⅱ or PLMA. The side effects in 24 h after surgery were recorded.Results Insertion was successful in all the patients. During either spontaneous breathing or controlled ventilation, the peak airway pressure was significantly higher in the patients with LTS Ⅱ than in the patients with PLMA ( P ＜ 0.05), and there wag no significant difference in the other ventilatory parameters between the two devices. There was no significant difference in the incidences of postoperative complications among the groups ( P ＞ 0.05) . Conclusion The efficacy of PLMA for airway manage ment is better than that of LTSⅡ during general anesthesia.

The accuracy and repeatability of computer aided cervical vertebra landmarking (CACVL) were investigated in cephalogram. 120 adolescents (60 boys, 60 girls) aged from 9.1 to 17.2 years old were randomly selected. Twenty-seven landmarks from the second to fifth cervical vertebrae on the lateral cephalogram were identified. In this study, the system of CACVL was developed and used to identify and calculate the landmarks by fast marching method and parabolic curve fitting. The accuracy and repeatability in CACVL group were compared with those in two manual landmarking groups [orthodontic experts (OE) group and orthodontic novices (ON) group]. The results showed that, as for the accuracy, there was no significant difference between CACVL group and OE group no matter in x-axis or y-axis (P>0.05), but there was significant difference between CACVL group and ON group, as well as OE group and ON group in both axes (P<0.05). As for the repeatability, CACVL group was more reliable than OE group and ON group in both axes. It is concluded that CACVL has the same or higher accuracy, better repeatability and less workload than manual landmarking methods. It's reliable for cervical parameters identification on the lateral cephalogram and cervical vertebral maturation prediction in orthodontic practice and research.

Objective Short-segment fixation is one of the most commonly used methods for the management of thoracolumbar vertebral fractures.In this study, we compared the clinical effects of short-segment fixation via and across the injured vertebrae in the treatment of thoracolumbar vertebral fractures . Methods We retrospectively analyzed 75 cases of thoracolumbar vertebral fractures treated by short-segment fixation, 39 via the injured vertebrae (group A) and 36 across the injured vertebrae (group B).We obtained the pre-and post-operative anterior vertebral body height ratio (AVBHr) and sagittal Cobb angle, operation time, and intraoperative blood loss, and compared them between the two groups of patients . Results Compared with the baseline, the AVBHr and the sagittal Cobb angle were significantly restored after surgery in both groups A ([56.32 ±12.53] vs [85.76 ±11.48]%and [20.41 ±5.73] vs [8.72 ±5.34]°, P<0.05) and B ([57.67 ±13.81] vs [83.51 ±12.54]%and [19.87 ±5.76] vs [9.18 ±5.42]°, P<0.05).The last follow -up examinations showed the AVBHr and Cobb angle to be (81.74 ±10.38)% and (10.93 ±6.32)°in group A and (76.82 ±11.06)%and (15.42 ±6.14)°in group B (P<0.05), with statistically significant differences from the postoperative parame-ters in group B (P<0.05).However, no remarkable differences were found between the two groups in the operation time or intraopera-tive blood loss (P>0.05).The losses of the AVBHr and Cobb angle were (3.78 ±1.24)%and (2.25 ±1.06)°in group A, signifi-cantly lower than (6.69 ±2.52)% and (6.31 ±2.18)°in group B (P<0.05). Conclusion For thoracolumbar fractures, short-segment fixation either via or across the injured vertebrae can effective-ly improve the vertebral height and Cobb angle , but fixation via the injured vertebrae may achieve a better maintenance of correction .

Objective To evaluate the clinical results of surgical treatment of isolated fractures of the sustentaculum tali of calcaneus via medial approach.Methods The data of 23 patients with isolated fractures of the sustentaculum tali of calcaneus was retrospectively analyzed who were treated with open reduction and internal fixation with cannulated screw or Kirschner wire via medial approach from September 2006 to March 2011.There were 19 males and 4 females,with an average age of 26.3 years (range,17-41 years).Associated injuries included 4 cases of talus fracture,4 of metatarsal fracture,and 3 of cuboid fracture.The functions of hiudfoot were assessed by American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores pre-operation and post-operation respectively.Results Fifteen patients got followed up with an average 20.5 months (10-56 months).Thirteen patients were rated as good,2 as excellent,and the excellent and good rate was 100％(15/15).All the fractures were stabilized reliably,and got clinical union with no obvious complications occurred.Time of fracture union was 8-10 weeks,with an average of 8.5 weeks.Three patients felt mild transient pain during the recovery of walking,but their pain disappeared quickly after physical therapy.No patients developed wound infection,nonunion and other complications.Conclusion For isolated fractures of the sustentaculum tali of caleaneus with articular surface displaced greater than 1 mm or involving the articular surface of middle subtalar joint,open reduction and internal fixation operation via medial approach under direct visualization is recommendable.

Objective To evaluate the significance of weight-bearing lateral radiographs in evaluation of malunited frac-tures of the ankle. Methods 17 patients with malunited fractures of the ankle were treated by different reconstructive operations be-tween March 2010 and October 2012, including 9 females and 8 males, aged from 17 to 64 years. According to the Takakura classifi-cation of ankle arthritis, there were 7 patients in grade 1, 4 in grade 2 and 6 in grade 3. Simple open reduction and internal fixation were performed in 5 patients, supramalleolar tibial osteotomy in 5, lengthening osteotomy of the fibula in 2, supramalleolar tibial and fibular osteotomy in 5. Tibiofibular clear space on the anteroposterior radiograph. Medial clear space, tibiofibular clear space and tib-iofibular overlap on ankle mortise radiographs were compared preoperatively and at last follow-up. Tibial lateral surface angle (TLS), the offset of the center of talar rotation from the tibial axis, and the displacement of tibiotalar articular surface center on weight-bear-ing lateral X-ray were also compared preoperatively and at last follow-up. AOFAS score was used to evaluate the function of the ankle. Results The duration of follow-up was 9 to 32 months. Bone healing was observed in all patients, and the average healing time was 11 to 14 weeks. Ankle joint degeneration grade had no exacerbation. The medial clear space, tibiofibular clear space and tibiofibular overlap had no significant difference between the pre and postoperative. Statistically significant change was seen postoperatively in the values of TLS (76.9°±4.1° vs 80.9°±5.2°). The offset of the center of rotation from the tibial axis and the displacement of tibiotalar articular surface center were changed from 10.8 ± 2.1 mm to 2.0 ± 0.5 mm and 4.5 ± 1.5 mm to 2.2 ± 1.0 mm, respectively. The average AOFAS score was improved from 45.7 ± 15.9 points preoperatively to 82.0 ± 9.9 points postoperatively. Conclusion Weight-bearing lateral radiographs can be used to judge the ankle restoration. Even if the mortise radiograph had relative good realignment, it may ap-pear obvious deformity on lateral radiographs. Good reduction of lateral radiographs requires that the mid axis of the tibia should pass through the center of talar rotation and tibiotalar articular surface be parallel on the lateral radiograph.

Objective To investigate the clinical curative result of the new method of postermedial deepen of the fibular groove in the treatment of chronic peroneal tendon subluxation.Methods From March 2006 to October 2012,21 patients (15 male,6 female) with chronic peroneal tendon subluxation via a novel method of postermedial deepen of the fibular groove.In this group:Ⅰ grade 5 cases;Ⅱ grade 9 cases;Ⅲ grade 5 cases;Ⅳ grade 2 cases.All patients were followed up for at least 24 months.The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale score and visual analogue score (VAS) were used to evaluate the clinical outcomes.Operation time,time to heal and complications were also recorded.Results The average operation time was 50 minutes (30-70 minutes).The blood loss was 30-60 ml,average 40 ml.All incisions healed after operation,no case of incision infection,skin necrosis and sural nerve,vascular injuryed.Mean AOFAS score was significantly increased from (55.2±7.1) preoperative to (93.6±5.6) postoperative.15 patients with excellent,good for 1 cases.The excellent and good rate was 100％ (16/16).VAS score by an average of (5.3±2.1) points down to (1.2±1.1) points postperative.All the patients can wear normal shoes postoperative,waking with normal gait.No patients had peroneal tendon tenosynovitis,tendon adhesion,fracture of lateral malleolus and other serious complications,no dislocation recurrent,strength of the peroneal muscle returns to normal.Conclusion The novel method of postermedial deepen of the fibular groove in the treatment of chronic peroneal tendon subluxation was safe and effective for ankle instability with a relatively short time.