BACKGROUND:With the development of AO, the treatment of intercondylar humeral fractures with open reduction has been a trend. However, the methods of fixation become many. There is no conclusion of which method is optimal.
OBJECTIVE:To investigate the clinical effect of two kinds of different fixation methods (Y-type steel plate and double steel plate) for intercondylar humeral fractures via different surgical approaches.
METHODA retrospective analysis of clinical data of 86 cases of fresh intercondylar humeral fractures in the Department of Orthopedics, Sixth Affiliated Hospital, Xinjiang Medical University, between December 2003
and May 2014 were conducted in this study. According to the different fixation materials, patients were divided into two groupdouble steel group (n=44, including the surgical approach of ulna olecranon osteotomy which had 22 cases and the surgical approach of triceps V shaped severance which had 22 cases), Y-type steel group (n=42, including the surgical approach of ulna olecranon osteotomy which had 21 cases and the surgical approach of triceps V shaped severance which had 21 cases). The clinical curative effect and related complications of the two groups after operation were analyzed. During fol ow-up, modified Cassebaum elbow scoring system was used to evaluate the excellent and good rate of therapy.
RESULTS AND CONCLUSION:After fol owed up for 12-36 months, the total excellent and good rate of Y-type steel plate was 76%and the total excellent and good rate of double steel plate was 77%. There were no significant differences between the two groups (P>0.05). But interestingly, the surgical approach of ulna olecranon osteotomy was better than the surgical approach of triceps V shaped severance and the difference was statistical y significant (P<0.05). Above data suggested that Y-type steel plate and double steel plate were effective ways in the repair of intercondylar humeral fractures. However, for different surgical approaches, the surgical approach of ulna olecranon osteotomy was better than the surgical approach of triceps V shaped severance.

Objective To create a new animal model which can preferably simulate the human's scoliosis. Methods Forty-five 4-week-old female Wistar rats were randomly divided into 3 groups. Group 1 underwent subcutaneous left scapula-to-contralateral ilium tethering procedure with a non-absorbable suture,which made the spine convex towards right side, and then removed forelimbs and tails of rats to create the bipedal rats. Tethering sutures were cut at postoperative 8th week, and the spines of rats were then observed during 2 weeks. Group 2 were the same as group 1 but in which scapula-to-ipsilateral ilium tethering procedure was performed. Group 3 were the same as group 1 except that the bipedal rats were not created. All postoperative rats were fed separately in special high cages for group 1 and group 2 or in standard cages for group 3. Operative duration, postoperative first food-taking duration, operative mortality, body weight, relative length of the spinal cord, Cobb angles in the coronal and sagittal planes, modeling mortality, the incidences of re-operation, scoliosis and vertebral rotation among the 3 groups were compared. Results There were no significant differences in the degree of scoliosis or kyphosis among the 3 groups at the time of initial tethering. At 2 weeks after tether release, the incidence of vertebral rotation was significantly higher in group 1 than group 2 (86.7% vs. 33.3%), and the degree of scoliosis or kyphosis was significantly larger in group 1 than group 3 (coronal plane: 30.2°±10.4° vs. 20.5°±7.7°; sagittal plane: 55.6°±10.0° vs. 43.8°±6.3°). There was no significant difference in postoperative first food-taking duration among the 3 groups, and no death of rats occurred in all groups during intraoperative and postoperative 6 hours, although operative duration was significantly longer in group 1 or group 2 than group 3. There were no significant differences in body weight,relative length of the spinal cord, modeling mortality, the incidences of re-operation and scoliosis among the 3 groups. Conclusion The bevel and axial loads of the vertebrae can significantly enhance the incidence of vertebral rotation and the degree of kyphoscoliosis, respectively. The scoliosis model created by scapula-to-contralateral ilium tethering procedure in bipedal rats can preferably simulate the human's scoliosis.

Objective To know the situation of teaching and teacher preparation for nursing under-graduates, and then reference to reasonable clinical teaching mode. Methods Investigated clinical pre-ceptors from 30 hospitals by serf-designed questionnair to know their basic situation, and then investigated nursing undergruaduates who had enter school in 2004 to know their evaluation about their preceptors in the aspect of basic quality. Results In professional tides, most of the teachers are nurse-in-charge, and have been working over 10 years, but qualification certificates levels were low and 50% of them teaching. Experience was short and not qualified to the popurse of bachelors degree, nurse-in-charge and more than five years nursing experience. The ratio in thesis writing, teaching training and awards are rather low. There were teaching assessment from students, mainly in teaching and research initiative. Conclusions The qualities of nursing teachers should be defined and should be established standard teaching training system and qualification organization, the capabilities of teaching and research innovations should be improved.

Nowadays, the research performance evaluation in Traditional Chinese Medicine (TCM) is basically exploring the principles and rules. What become the problems are that what index system can fully reflect the TCM performance evaluation, and what method can reflect the characteristics of TCM performance evaluation. Analyzing the status of the Korean research performance evaluation, we briefly disseminated how to establish the TCM performance evaluation.

Objective To provide a representative,objective and operable evaluation tool for agsessing tlle quality of clinical internship of nursing students,and through fuzzy evaluation and feeding back information scientmcauy to improve clinical teaching quality comprehensively.Methods Employing the method of"sorting of experts contrast"to score assessing indicators according to the importance in the undergraduate nursing internship by 10 experts,using mathematical methods to calculate the index weight,and applying fuzzy mathematics to the quality evaluation of nursing internship. Results The project had appropriate indicators and objective and reasonable weight.By applying this system,the general state of intemship students asessod by the clinical teachers and the head nurses was evaluated fuzzily,which was in accordance with the actual performance of students.Conclusions The index system with the characteristics of modern practice teaching concepts combines comprehensiveness with innovation,importance with completeness,accords with the teaching goals of nursing students,and the fuzzy evaluation of that will be better to evaluate the internship quality of nursing students comprehensively and objectively.

Objective To investigate the methods of anesthesia,infusion and the skill of removing urinary calculus for the treatment of uretemlith stones using ureterescope air pressure path lithoclasty.Methods Six hundred and ninety ureterolith stone patients using ureterescope air pressure path lithoclasty,383 patients were anesthetized by single sacro-anesthesia,and the diclofenac sodium suppositories were added in 312 cases to strengthen the anesthesia effeets.Antegrade perfusion with furosemide in the operation was used.Results Broken the stones in orthophoria were successful in 645 patients.the total success rate Was 93.5%and the total rate of removing urinary calculus was 93.8%.Conclusions Ureteroscope air pressure path lithoclasty is high efficiency,safety and easy manipulation.It is a satinfactory method for the treatment of ureterolith stones,and the correct method of anesthesia and infusion perfect skill of removing urinary calculus can improve the rate of removing urinary calculus and decrease the costs.

Objective To systematically review the application effects of bundles nursing on pressure ulcer nursing intervention of elderly patients. Methods Clinical control trails of the application effect of bundles nursing on pressure ulcer nursing of elderly patients were searched using computer in cooperation with manual retrieval from SinoMed,VIP,CNKI,and WanFang database. Two reviewers independently searched and extracted data, screened captured citations,and assessed methodological quality of all included studies. RevMan 5.3 software was used for Meta-analysis. Results Twenty-nine literatures were included for systematic review with 3 020 cases. Meta-analysis showed that,bundles nursing significantly increased the effective rate of pressure ulcer treatment of elderly patients [RR=1.26,95%CI (1.22,1.31)],and improved the degree of nursing satisfaction [RR=1.18, 95%CI (1.12,1.25)] when compared with the usual care group. The differences were statistically significant (P< 0.05). Conclusions Bundles nursing can significantly increase the effective rate of pressure ulcer treatment of elderly patients,and improve the nursing satisfaction,so it is worthy of promotion.

Objective:To explore the willingness to use mobile healthcare in patients with gout and explore its influencing factors, and provide theoretical guidance for optimizing the gout mobile healthcare platform and improving patients' willingness to use it.Methods:This study was a cross-sectional study. Totally 234 patients with gout who attended the outpatient service in Shandong Provincial Gout Clinic Medical Center from November 2019 to January 2020 were selected by convenient sampling, and investigated with a self-designed general information questionnaire and questionnaire of gout patients' willingness to use mobile healthcare and its influencing factors. Univariate analysis and multiple linear regression analysis were used to analyze the influencing factors of gout patients' willingness to use mobile healthcare.Results:A total of 53.85% (126/234) of patients with gout mainly used gout WeChat official account as a form of mobile healthcare, and the commonly used functions were diet guidance (64.96%, 152/234) , disease knowledge (60.26%, 141/234) , exercise guidance (54.27%, 127/234) ; 47.01% (110/234) of patients were not satisfied with mobile healthcare. The gout patients' willingness score to use mobile healthcare was (10.91±3.28) . Univariate analysis showed that there were statistically significant differences in the willingness scores of patients with different personal monthly income, education level, and whether have comorbid diseases ( F/t=12.511, 6.343, -2.229; P< 0.05) . Regression analysis showed that the influencing factors of gout patients' willingness to use mobile healthcare included perceived susceptibility, perceived severity, perceived benefits, perceived barriers, information quality and system quality (adjust R2=0.446, P<0.01) . Conclusions:The willingness of gout patients to use mobile healthcare services is at a moderately high level, and there are differences between different individuals. The willingness to use mobile healthcare is affected by patients' health beliefs and the quality of mobile healthcare information systems.

Objective:To explore the impact of pain, functional disability, self-efficacy and social support on health-related quality of life (HRQOL) in gout patients.Methods:From November 2019 to January 2020, a total of 218 patients with gout were investigated using the general information questionnaire, Visual Analogue Scale, Health Assessment Questionnaire Disability Index, General Self-Efficacy Scale, Perceived Social Support Scale, and Gout Impact Scale. The structural equation model was established by AMOS 24.0 for parth analysis, and the mechanism of pain dysfuction, self-efficacy and social support affecting the quality of life in gout patients was tested.Results:The total score of Gout Impact Scale, pain, functional disability, self-efficacy and social support respectively was 59.94±18.39, 6.00±2.76, 0.25 0, 0.88, 23.39±6.40 and 62.92±8.24. Pain directly influenced HRQOL ( β=-0.293, P<0.01), and indirectly influenced HRQOL ( β=-0.039, P<0.05). Functional disability directly influenced HRQOL ( β=-0.244, P<0.01). Self-efficacy directly influenced HRQOL ( β=0.182, P<0.01), and indirectly influenced HRQOL ( β=0.202, P<0.01) through pain and functional disability. Social support indirectly influenced HRQOL ( β=0.278, P<0.01) through pain, functional disability and self-efficacy. Conclusions:HRQOL of patients among gout is affected by several factors, mainly affected by pain, functional disability and self-efficacy; and there are interactions among them. Targeted interventions should be strengthened to relieve pain, prevent or slow down the progress of physical disability, enhance self-efficacy and social support to improve HRQOL.

Objective Based on lung cancer center database,we analyzed the clinical characteristics of lung patients with bone metastases.The relationship between bone metastases,skeletal-related events,survival time and different pathological subtypes of lung cancer were also evaluated in this study.Methods A total of 861 patients with lung cancer were studied from May 2010 to April 2012 at Tianjin Medical University Cancer Institute and Hospital.As to follow-up situation,patients' survival status and treatment information were collected by telephone follow-up and (or) examinationsin outpatient.The clinical characteristics,skeletal-related events and survival of bone metastaticpatients with different pathological types of lung cancer were analyzed.Logistic regression analysis was used to identify risk factors for bone metastases.The relationship between histological subtypes and the incidence of bone metastases was evaluated using Odds Ratios (ORs).The chi-square test was used to compare the proportion of bone metastases,synchronous bone metastases and SREs among different histological subtypes patients.The overall survivals was evaluated using the Kaplan Meier.Results A total of 861 patients with lung cancerwere enrolled in this study,including 293 cases with bone metastases.The average follow-up of our population was 14.2 months and the last follow-up time was September 2017.Among different pathological types of lung cancer,adenocarcinoma (39.14％,173/442) has the highest incidence of bone metastases,followed by other types (29.91％,35/117),squamous cell carcinoma (29.47％,56/190) and SCLC (25.89％,29/112).Spine (59.73％,175/293) was the most common location site of the bone metastases,followed by the ribs (49.15％,144/293),pelvis (20.48％,60/293),femur (16.38％,48/293) and sternal (16.38％,48/293).Lung adenocarcinoma was a risk factor for bonemetastases (P=0.002).In ORs analyze,adenocarcinoma patients were more likely to develop bone metastases [OR=1.60,95％CI (1.21～2.13)].In our cohort,58.36％of patients with lung cancer had skeletal related events.Among various types of skeletal related events of patients with bone metastases,the most common one was radiotherapy for bone metastases (51.88％,152/293),followed by pathological fractures (15.02％,44/293),spinal cord compression (6.48％,19/293),bone instability requiring surgery (4.78％,14/293) and hypercalcemia (1.71％,5/293).There was no significant difference between different types of skeletal related events.The median survival time of the patients with bone metastases was 11.5 months.There was no significant difference in survival between adenocarcinoma patients and non-adenocarcinoma patients (P=0.111).Conclusion This study suggested that the incidence of bone metastasis in lung adenocarcinoma was 39.14％ and lung adenocarcinoma was a risk factor for bone metastases,which supported early screening and monitoring of bone metastasis in the patients.