Objective To explore clinical effect of self-made traditional Chinese medicine for hand-foot-mouth disease.Methods 118 cases with hand-foot-mouth disease were randomly divided into two groups.The control group(n=59)were treated by regular western medicines.On that basis,the study group(n=59)were treated bys elf-made traditional Chinese medicine.And the curative effects of two groups were observed.Results Fever subsidise time of the study group after treatment was(2.0±0.7)d,which was significantly shorter than that of the control group,with P＜0.05.Rash subsidise time of the study group after treatment was(3.9±0.9)d,was significantly shorter than that of the control group,with P＜0.05.Length of hospital stay of the study group after treatment was(3.5±1.3)d,was significantly shorter than that of the control group,with P＜0.05.Total effective rate of the study group after treatment was 94.9％,which was significantly higher than that of the control group(81.4％),with P＜0.05.Conclusion Self-made traditional Chinese medicine for hand-foot-mouth disease has good clinical curative effect,has high security and reliability.

Objective To explore the diagnosis and treatment of the fracture of posterior medial tubercle of the talus (PMTT). Methods From June 1993 to January 2002, eighteen patients were definitely diagnosed by CT scan as fractures of PMTT, but three of them had been misdiagnosed at their first visit. Of the 14 patients of them whose subtalar joint was involved, open reduction and internal fixation (ORIF) was adopted in eight, plaster cast fixation in five, and conservative management in one who had rejected any surgical procedures. Of the other four cases, plaster cast fixation of six weeks was applied in three, and excision of fracture fragments was performed in one. Results The mean follow-up was 41.7 months. Evaluation was done according to AOFAS (American Orthopedic Foot & Ankle Society) system. Satisfactory outcome was achieved in one of the first misdiagnosed patients after excision of fracture fragments. Of the others who received operative treatment, excellent result was achieved in seven cases, good in six cases and fair in three cases. The result for the one who refused surgery was poor. Conclusions The fracture of PMTT should be definitely diagnosed by CT. It should be treated operatively by means of internal fixation with half-threaded Titanium screws. Satisfactory outcome can be achieved by excision of fracture fragments for patients who were misdiagnosed at first.

Objective To summarize the early complications caused by the screws of AO titanium plate in the operative treatment of the displaced intraarticular calcaneus fracture (DIACFs). Methods 60 patients with calcaneal fractures were treated with ORIF (open reduction with internal fixation) using the AO plate. Results All the cases were followed up for 22 months. There appeared 1 case of screw loosening and 2 cases of improper screw location. Conclusion Although the AO titanium plate can improve the anatomic restoration of the calcaneus shape, sufficient preoperative preparation should be made to secure accurate placement of the screws so that the screw problems can be reduced.

Objective To compare the effect and complications of lumboperitoneal shunt (LP) and ventriculoperitoneal shunt (VP) in treatment of posttraumatic hydrocephalus (PTH).Methods A retrospective study was made on 150 cases of posttraumatic communicating hydrocephalus managed with LP or VP from June 2013 to June 2015.There were 65 cases [36 males, 29 females;(47.2 ±8.2) years of age] in LP group and 85 cases [53 males, 32 females;(44.6 ± 7.3) years of age] in VP group.Therapeutic effect and complications were analyzed postoperatively.Results Period of follow-up was 3-27 months, which shoued Total effective rate of 97％ in LP group and 94％ in VP group (P ＞0.05).Postoperative complications were mainly hematoma, infection, shunt obstruction, shunt exposure, excessive shunt and inadequate shunt.At the follow-up, there were 3 subdural hematoma, 4 intracranial infection, 2 shunt obstruction, 3 excessive shunt and 1 inadequate shunt in VP group, but 1 subdural hematoma, 1 intracranial infection, 1 shunt exposure and l excessive shunt in LP group.Good results were achieved in the two groups after regulation of the shunt pressure or reoperation.In comparison, incidence of complications was 6％ in LP group versus 15％ in VP group (P ＜ 0.05).Rate of shunt removal and reoperation in LP group were both 2％, but were 7％ and 8％ respectively in VP group (P ＜ 0.01).Conclusions Both shunt procedures are effective for posttraumatic hydrocephalus, while LP is a better choice in clinical application for the lower complication incidence, shunt removal rate and reoperation rate.

Objective To explore the short-term clinical outcomes of ankle arthrodesis for the treatment of posttraumatic ankle arthritis.Methods Retrospectively study the data of 47 patients with posttraumatic ankle arthritis who were followed up after receiving ankle arthrodesis from January 2008 to May 2012.There were 28 males and 19 females,with an average age of 44 years (range,14-72 years).All of them wereclassified into stage-3 arthritis according to Morrey-Wiedeman,among whom 31 had obvious foot varus deformity or equines deformity,and 16 were almost normal in appearance.The ankle joint function of patients were assessed by Kofoed,American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score,Maryland foot score systems and visual analog scale (VAS) preoperatively and at the last follow-up.Results The patients were followed up from 5 to 52 months (average,25 months).All the ankles got fused at the last follow-up,with one receiving removal of internal fixation and debride because of infection.Forty-three patients were satisfied with or without reservations; the others thought it so.The satisfaction rate was 91.5％(43/47).The Kofoed,AOFAS,Maryland foot scores and VAS were significantly improved from 48.11 ±5.00,53.38±5.52,49.74±5.71,7.89±0.87 to 80.96±6.07,82.21±4.26,88.94±5.14,2.28±1.10 respectively at the last follow-up.The normotopia X-ray of ankle joint showed that there were 22 cases in which the ankle got fused at neutral position,19 cases in which the eversion was less than 5°,3 cases in which the eversion was between 5° to 10°,2 cases in which the varus was less than 5°,and 1 case in which the varus was between 5° to 10°.Lateral X-ray showed that there were 32 cases in which the ankle got fused in dorsiflexion neutral position,12 cases plantar flexion 5°,and 3 cases plantar flexion 5° to 10°.Conclusion Ankle arthrodesis is still the preferable surgical treatnent option in patients with end-stage ankle arthritis,which shows high reliability and effectively in correcting deformity,pain relieving and function improvement.

Objective:To observe the technique of using the random flap with a subcutaneous pedicle forone-stage reconstuction of anterior auricular conchal defect and its efficancy.Methods:Ten cases were involved in this study, including 3 cases of carcinoma, 6 cases of nevus, and one with iatrogenic detect. Six patients were men, and 4 were women. Their ages were 2 months to 68 years (mean 57 years). Surgical defect size ranged from 1.0 cm×1.0 cm to 2.5 cm×1.5 cm. They were resected and reconstructed using the retroauricular random flap of the subcutaneous pedicle.Results:10 wounds were healed by first intention. The appearance and functionality of the flap matched well with the receiptive site. During 6 to 24 months of follow-up, no tumor or nevus recurred. All patients were satisfied with the aesthetic results of the POSAS assessment scale.Conclusions:Aesthetic results are achieved with satisfactory appearance and functionality by this easy-to-learn technique in comparative short surgical time.

Objective:To analyze the categories, scoring methods and effects of dietary patterns in heart failure patients, systematically.Methods:The databases such as Medline, Embase, and Cochrane were searched to obtain articles on dietary patterns of heart failure patients up to December 31, 2019. Arksey and O′Malley's scoping review method was applied to analyze the articles.Results:A total of 1 500 studies were identified, 21 of them met the inclusion criteria. These studies mainly studied Mediterranean diet(11 articles), Dietary Approaches to Stop Hypertension Diet(7 articles), Palaeolithic diet(1 article), low fat diet(1 article), High-protein Diet(1 article).Conclusions:The Mediterranean and DASH dietary patterns have a positive protective effect on heart failure disease prevention and treatment, but more randomized controlled trials are needed to improve the reliability of the conclusions.

Objective To evaluate primary open reduction and wire-pin fixation for total dislocation of talus.Methods A retrospective study was conducted of the 12 patients who had been admitted into our hospital from October 2009 to December 2013 for total talar dislocation without fracture of the talar neck or body and had been available for complete follow-up.They were 10 males and 2 females.Their range of age was from 17 to 56 years (average,34.2 years).The total dislocation was open in 4 cases and close in 8.All of them underwent primary open reduction and wire-pin fixation.The functions of ankle joint and hindfoot were evaluated according to the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale.Results The follow-up time ranged from 22 to 72 months (average,35.6 months).Postoperatively,one case suffered skin necrosis and another superficial infection,both of whom responded to skin flap transferring after debridement.Traumatic arthritis of the talotibial or subtalar joint was found more or less in 7 cases,one of whom complained of severe pain but refused the subtalar arthrodesis advised.Their AOFAS scores at the final follow-up ranged from 42 to 96 points (average,72.2 points).Five cases developed avascular necrosis of the talus,but no talar collapse happened.Conclusions Primary open reduction and wire-pin fixation is effective for treatment of close total talar dislocation and open total dislocation of Gustilo type Ⅲ A or below.Although avascular necrosis and traumatic arthritis are common postoperative complications,satisfactory functions can be achieved if there is no collapse,severe pain or infection.

Objective To compare biomechanical effects of augmentative plating assisted by different types and numbers of intramedullary nails in the treatment of nonunion of femoral shaft fracture after intramedullary nailing.Methods Twenty-five specimens of synthetic femur were randomly divided into an experimental group (20 bones) and a control group (5 bones).All the bones were made into models of nonunion of femoral shaft fracture after intramedullary nailing.The control group was subjected to no augmentative plating.The experimental group was further divided into 4 subgroups (n =5) which were subjected to fixation respectively by:a 7-hole plate with 3 bicortical screws on each side,a 7-hole plate with 3 unicortical screws on each side,a 5-hole plate with 2 bicortical screws on each side,and a 5-hole plate with 2 unicortical screws on each side.The torque values of all the subgroups were measured and compared when the models were subjected to torsional angles of 5°,10°,15°,20° and 25°.Results The anti-torsional strengths at torsional angles of 5°,10°,15°,20° and 25° in the 4 experimental groups were all significantly greater than in the control group(P ＜ 0.05).At a torsion angle of 25°,the mean torque value in the 3-bicortical-screw group (46.51 ±6.66 nm) was significantly greater than in the 2-bicortical-screw group (39.03 ±8.52 nm) (P ＜0.05).At torsion angles of 5°,10°and 25°,the mean torque values in the 3-unicortical-screw group (13.48±1.68 nm,23.29±3.72 nm and 48.19±5.34 nm,respectively) were significantly greater than in the 3-unicortical-screw group (9.56 ± 3.62 nm,16.99 ± 5.49 nm and 38.69 ± 6.56 nm,respectively) (P ＜ 0.05).At torsion angles of 20° and 25°,the mean torque values in the 3-unicortical-screw group (39.15 ± 5.07 nm and 48.19 ± 5.34 nm) were significantly greater than in the 2-bicortical-screwgroup (32.50 ± 5.65 nm and 39.03 ± 8.52 nm) (P ＜0.05).Conclnsions The anti-torsional strength of fixation by 3 screws on each side is significantly greater than by 2 screws on each side.When the number of screws is the same,there is no significant difference between fixation by unicortical locking screws and that by bicortical conventional screws.Augmentative plating with 3 unicortical screws or 3 bicortical conventional screws on each side is recommended for treatment of nonunion of femoral shaft fracture after intramedullary nailing.

Objective To explore the clinical results of total ankle replacements with the Scandinavian Total Ankle Replacement (STAR) prosthesis for end-stage ankle arthritis.Methods Data of 73 cases with end-stage ankle arthritis who received Scandinavian total ankle replacement from January 2005 to May 2013 were retrospectively analyzed.They were 34 males and 39 females,with an average age of 59.6 years old (range,37-76 years old),average body mass index (BMI) of 25.3 kg/m2 (range,21.8-28.0 kg/m2).All patients were classified into stage-3 arthritis according to Morrey-Wiedeman.Kofoed,American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score and visual analog scale (VAS) were used to evaluate the function of foot and ankle.Patients with a hindfoot deformity below 10° were compared with those who above 10°;and patients above 55 years old were compared with those who below it.Results 5 replacement failed (2 liner ruptured and received replacement;2 metal components displaced,1 received TTC fusion and the other underwent revision with inferior tibiofibular joint fusion,the last patient suffered from deep infection and received the STAR removal and secondary fusion) in 73,and the rest were followed up for 12 to 110 months (average,55.2 months).59 patients were satisfied with or without reservations.The satisfaction rate was 80.8％ (59/73).The pre-op values of AOFAS,Kofoed,VAS and range of motion (ROM) were 46.6±3.5,43.0±4.7,8.7±0.7,34.4°±7.1° and the post-op values were 86.6±4.3,82.6±4.6,3.0±1.0,45.1°±8.2° respectively,and all were significantly improved compared with before.The AOFAS,AOFAS Function and ROM values of patients below 55 years old were 86.1±3.8,47.0±2.7,45.7°±7.0°,and the same values of patients above 55 were 86.7±4.6,46.8±3.1,44.9°±8.8°.The AOFAS,AOFAS Function and ROM values of patients with above 10° coronal deformity were 86.1±4.7,47.0±2.7,43.0°±7.7°,and the same values of patients below 10° were 86.8±4.2,46.8±3.1,46.1°±8.2°.There was no difference between the groups.Conclusion The STAR is the preferable surgical treatment option in patients with end-stage ankle arthritis,showing high reliability and effectivity in pain relieving and function improvement.