[Objective] To investigate the diagnosis and treatment of congenital oblique talus in clinical practice.[Methods]Clinical situation of thirty-one patients displayed tarsoptosis and pas valgus,collapse in medial longitudinal instep,and with no talipes calcaneus,no contraction of tendon and no rigidity.All instep of the patients were restored to normal by chirismus.The X-ray of normotopia showed that axial ray of talus was declivent to wall and was angulated with No.1 metatarsal bones.The X-ray of lateral position showed that semiluxation of articulatio talonavicularis was noted,and axial ray of talus and No.1 metatarsal bones was not normal.The X-ray of lateral position of maximal plant flex and entropion showed that axial ray of talus and No.1 metatarsal bones was normal.Twenty-seven cases were cured by manipulation,4 cases were cured by operation,31 cases were cured by orthopaedic orthosis.[Results]All cases were curative during a follow-up of 12 to 24 months(mean,10 months).All outline forms of feet were good and no valgus calcaneus was found,the medial longitudinal instep were restored,the function of ankle and toes was normal,and the pedal force of enstrophe with ecstrophy was balance.The X-ray of normotopia showed that the angle of axial ray of talus to No.1 metatarsal bones was normal in 26 cases and ≤10? in 5 cases.Kite's angle was normal in 29 cases and ≤20? in 2 cases.The X-ray of lateral position showed that articulatio talonavicularis was good in 29 cases and ≤25? of talus to calcaneus in 6 cases.[Conclusion]Congenital oblique talus in infants can be cured by manipulation or operation.The prognosis is good.

Objective To investigate the correlation between the levels of Hcy ,VitB12 and folic acid with Alzheimer′s Disease(AD) .Methods Fifty-four patients with AD in this hospital were extracted as the AD group by using cluster sampling method ,and contemporaneous 50 persons undergoing healthy physical exami-nation were selected as the control group .The levels of serum Hcy ,VitB12 and folic acid were detected in the two groups .Then the correlation among 3 indicators was analyzed .Results Compared with the control group , the level of serum Hcy in the AD group was significantly increased (P<0 .05) ,the VitB12 and folic acid levels in the AD group were significantly decreased compared with the control group (P<0 .05) .The serum Hcy lev-el was negatively correlated with VitB12 and folic acid levels (r= -0 .751 ,-0 .807 ,P<0 .05) .The area under the receiver operating characteristic curves (AUC) of Hcy ,VitB12 and folic acid and their combine detection in AD patients were 0 .897 ,0 .176 ,0 .204 and 0 .933 respectively .Conclusion Serum Hcy ,VitB12 and folic acid have clinical diagnosis value in AD ,and the 3-indicator combined detection can increase the diagnosis efficiency .

【Objective】 To retrospectively analyze the guiding significance and effect of thromboelogram (TEG) in the clinical use of cryoprecipitation. 【Methods】 A total of 289 patients with fibrinogen reduction, admitted to our hospital between January 2018 and December 2021, were collected. They was divided into control group (using coagulation examination and clinical feature as the transfusion criteria) and observation group (above parameters plus TEG). The TEG index in the observation group before and after transfusion and Fg, APTT, PT, and TT in 2 groups of patients before and after transfusion were monitored. The efficacy and prognosis of different blood products and cryoprecipitate were compared between 2 groups of patients.) 【Results】 The efficacy of choprecipitate transfusion was better in the observation group than the control[Fg index after transfusion (g / L) 1.92±0.92 vs 1.80±1.00, P<0.05]. And less blood products were used in observation group as compared with the control[ RBC(U) 1.93±2.69 vs 2.81±3.25 (P<0.05); FFP(mL) 667±378 vs 879±455(P<0.05)]. No differences were noticed by hospital stay between the two groups, but the prognosis in the observed group was significantly better than that in the control. 【Conclusion】 It’s scientific and reasonable to apply TEG to guide the clinical transfusion of cryoprecipitate, so as to save blood resources and improve the prognosis.

【Objective】 To explore the effect of lactate and alkali deficiency on the need for red blood cell transfusion in emergency of patients with traumatic hemorrhagic shock. 【Methods】 A total of 126 patients with traumatic hemorrhagic shock in our hospital from January 2019 to December 2021 were retrospectively analyzed, and the 99 cases with effective treatment were divided into two groups according to the outcome of blood transfusion within 24 hours after admission: non-transfusion group (n=36) and transfusion group (n=63). The changes of lactic acid (Lac), alkali deficiency (BE), hemoglobin (Hb), hematocrit (Hct) at admission, hemoglobin (Hb), hematocrit (Hct) 24 hours after admission and the length of stay in ICU were compared between the two groups. The binary logistic regression was used to analyze the risk factors of whether there was a need for blood transfusion at the time of emergency admission. The correlation between individual and combined indicators of each risk factor and the need for blood transfusion were analyzed by the receiver operating curve (ROC). 【Results】 The mean level of Lac (2.90±1.82) in the non-transfusion group at admission was lower than that in the transfusion group (5.80±2.83) (P<0.05), while BE、Hb and Hct (-1.76±3.24, 120.78±20.83, 35.76±6.11) were higher than those in the transfusion group (-5.91±4.69, 101.32±29.68, 29.97±8.48) (P<0.05). The mean levels of Hb and Hct in the two groups 24 hours after admission (92.75±16.66, 78.49±15.91) and (27.62±5.24, 22.60±4.74) were lower than those at admission (P<0.05). Binary logistic statistical analysis confirmed that Lac (OR=1.74, 95% CI 1.493-2.927, P<0.01), BE (OR=0.77, 95% CI 0.676-0.883, P<0.01), Hb (OR=0.97, 95% CI 0.954-0.989, P<0.01), Hct (OR=0.90, 95% CI 0.844=0.96, P<0.01) had guiding significance for patients with traumatic hemorrhagic shock to have red blood cell transfusion demand, and the increase of blood lactic acid was an independent risk factor (P<0.05), while age and gender had no significant effect on it(P>0.05)The maximum AUG of Lac and BE(0.875, 0.766) in predicting the need for emergency red blood cell transfusion in patients with traumatic hemorrhagic shock was significantly better than that of Hb and Hct (0.692, 0.682); the optimal threshold for Lac was >3.6 mmol/L, while the optimal threshold for Hb is ≤106 g/L; the maximum AUG obtained by ROC curve analysis combined with Lac, BE, Hb and Hct was 0.910, which was higher than that of the sole virable. Comparative predictive value using the optimal thresholds of Lac and Hb as indications for transfusion showed that Lac had better predictive value than Hb. 【Conclusion】 Lac and be can be instructive for patients with traumatic hemorrhagic shock as to whether they need red blood cell transfusion in an emergency setting, and combination of Lac, BE, Hb and Hct may help to determine the transfusion needs of patients more timely and accurately and optimize the transfusion management of emergency patients.