Objective To evaluate the results of less invasive surgical treatment of high energy tibial plateau fracture, which involves limited open reduction, percutaneous screw fixation and Hybrid external fixation. Methods From 1999 to 2002, 12 cases of high energy tibial plateau fracture were treated with Hybrid external fixation. They were 8 males and 4 females. According to Schatzker classification, there were 9 cases of Type Ⅴand 3 cases of Type Ⅵin the group. The average age of the patients was 39.3 years old (ranging from 27 to 48). Results All were followed up for an average of 15 months (ranging from 6 to 27). All the fractures got united, with an average healing time of 3.2 months. All patients achieved 0 to 5 degrees of extension and more than 100 degrees of flexion. The patients had an average knee score of 88.7 and an average functional score of 85.2(Knee Society clinical rating system). 1 case had infection of pin holes, and 2 knees had Grade 2 arthrosis at radiographic check up two years after the operation. Conclusion Hybrid external fixation combined with limited open reduction is appropriate for treatment of the complex tibial fractures, especially those with a poor soft tissue envelope.

Objective To evaluate the effects of treatment for the distal radial osteoporotic fractures in elder patients with Volar Locking Compression Plating (LCP)fixation. Methods 30 old patients who suffered from the severe osteoporotic distal radial fractures were treated with LCP. In this group all the fractures were more severe than type 2B according to Melone classification. The results of treatment were evaluated by comparing pre and post operative functions and X rays of involved wrists. Results 26 of the 30 patients experienced no wrist pain and were satisfied with the functions of the suffered wrists in their daily postoperative activities. 2 patients still felt wrist pain and needed to take some pain killers and other 2 experienced mild finger movement limitations. These data were improved postoperatively to the average palmar tilt of 3.38 degrees, radial inclination of 18.9 degrees and the radial length 0.9cm longer between the ulnar head and the tip of the radial styloid. The radial length was found 0.2 mm shorter in 2 cases in the latest follow up than that measured before. No severe complications were found in this group. Conclusion For the unstable distal radial osteoporotic fractures in the elderly patients, Volar Locking Compression plating (LCP)fixation is one of the effective treatments, because this procedure can restore and sustain the distal radial length and smooth articular surface after the fracture reduction.

Objective Unstable intertrochanteric hip fractures are characterized by comminution of the posteromedial cortex and a fragment of variable size containing the lesser trochanter. This paper is to discuss whether it is necessary to perform reduction and fixation for this fragment. Methods 67 cases of intertrochanteric fractures were treated by dynamic hip screw (DHS) fixation between March 2001 and September 2002 and followed up for a minimum of 1 year. Their treatment results were retrospectively analyzed. Results No nonunion, coxa vara or failure of internal fixation occurred in all these patients. Conclusion If DHS provides stability, screw fixation of the lesser trochanteric fragment is unnecessary.

The Web portals of health information management organization gateway in USA, Canada and Australia were analyzed in aspects of their leading organizations , Web resources , types of user , relationship between users and resources in order to know their methods to organize resources and Website design , and certain suggestions were put forward for the Web portal construction of official gateway and related health information service institutions .

〔Abstract〕 Based on the retrieval sources of the official website of Inforway in Canada , Tongfang Knowledge Network and Internet re-sources, by investigating the conformance test of health informatization and health standards conducted by Inforway in Canada , the paper makes a comprehensive analysis of the conformance test of health information standards in Canada from 4 aspects, namely the certification subject, certification object , certification standard , certification process .It aims to provide references for the conformance test of health information standards in China .

Objective: Randomized controlled trials (RCTs) of Chinese patent medicines and classic traditional Chinese medicine prescriptions were systematically reviewed from both Chinese and English journals published in 2023. A preliminary summary and evaluation were conducted on the generation and translation of clinical evidence for these treatments. This analysis aims to inform future research on clinical efficacy evaluation and guide the rational application of evidence. Methods: RCTs of Chinese patent medicines and classic traditional Chinese prescriptions published in 2023 were comprehensively retrieved from the Artificial Intelligence Clinical Evidence Database for Chinese Patent Medicine (AICED-CPM), with supplementary searches conducted in China National Knowledge Infrastructure (CNKI), Wanfang Data, Chinese Science and Technology Journal Database (VIP), Chinese Biomedical Literature Database (SinoMed), Cochrane Library, PubMed, Embase, and Web of Science. The study characteristics and methodological quality of these RCTs were systematically analyzed and evaluated. Results: A total of 1 443 RCTs of Chinese patent medicines were included, comprising 1 399 Chinese articles and 44 English articles. Additionally, 334 RCTs of classic traditional Chinese medicine prescriptions were found, with 331 published in Chinese and 3 in English. 196 567 participants were included, covering 585 types of Chinese patent medicines (487 oral, 61 injectable, and 37 topical) and 179 classic traditional Chinese medicine prescriptions. The involved studies encompassed 22 types of diseases, with research primarily focusing on diseases of the circulatory system, the respiratory system, and the genitourinary system. The sample sizes ranged from 18 to 3 777 participants, and most studies were conducted at a single center. Methodologically, the implementation of allocation concealment and blinding remained insufficiently emphasized. Conclusion Overall, compared with 2022, both the number of RCT publications and their methodological quality have improved in 2023, with heightened attention to research on diseases of the genitourinary system. However, quality control and standardized management in the design and implementation processes still require enhancement to produce more high-quality clinical evidence and accelerate the translation and application of this evidence.

Objective:To provide a reference for establishing the evaluation system of the implementation effect of cross provincial direct settlement policy.Methods:By referring to the public policy evaluation model and using the expert consultation method, the authors built an evaluation index system for the implementation effect of cross provincial direct settlement policy for urban and rural residents. The multi-attribute group decision-making analytic hierarchy process, Matlab software and Yaahp software, combined with Spearman correlation coefficient method, were used to cluster the expert opinions and further determine the weight of each element at different levels.Results:The evaluation index system of the implementation effect of direct settlement policy for urban and rural residents′ cross provincial medical insurance was constructed, including 3 first-class indicators, 9 second-class indicators and 20 third-class indicators, and the weight of each index was calculated.Conclusions:The designed index system is suitable for grasping the implementation level of the cross provincial direct settlement policy from a macro perspective, and find out the problems in the implementation process. Efforts should be made to refine the evaluation criteria of the indicators in the index system.

By means of analysis of related national policies on medical alliances, and investigation of their current development in China, the authors summarized the conceptual category of existing medical alliances. Typical cases were selected for comparative analysis in terms of urban medical groups, medical communities, specialized alliances and telemedicine collaboration networks. In view of such setbacks found as lack of health services, ambiguity of power and duties of stakeholders, and low penetration rate of composite medical insurance payment, as well as lack of effective incentives and poor online diagnosis and treatment mechanism, the authors recommended on development of medical alliances in respect of framework improvement and mechanism optimization among others.

【Objective】 To study the characteristics of HIV infection among voluntary blood donors in Shijiazhuang from 2011 to 2021, so as to provide reference for decision making in the control of HIV for blood centers. 【Methods】 The confirmatory results of HIV reactive samples in initial screening among voluntary blood donors from 2011 to 2021 in our center were statistical analyzed. 【Results】 A total of 2 008 299 samples from 1 667 315 blood donors were detected, among which 3 217 samples were HIV reactive and 234 were confirmed positive, with the positive rate at 11.65/100 000 and the prevalence of 14.03/100 000. The prevalence in men was higher than that in women (16.52/100 000 vs 1.39/100 000), in first-time blood donors higher than that in repeated donors (17.27/100 000 vs 8.12/100 000), in whole blood donors higher than that in plateletpheresis donors (12.01/100 000 vs 8.41/100 000), and the differences were statistically significant (P<0.05). The male homosexual transmission was the main routes of transmission, accounting for 62.39% (146/234). And 72% of double-reagent reactive samples were confirmed positive. Four samples were screened in the serological window period and 6 samples were from HIV positive confirmed donors. 【Conclusion】 The HIV prevalence among voluntary blood donors in Shijiazhuang was low. A certain percentage of repeated blood donors got newly infected. NAT could shorten the detection window period of HIV. Since some confirmed positive samples had not been detected out by NAT, publicity and education should be strengthened to reduce the probability of infected or high-risk groups to participate in blood donation.

Objective:To analyze the filing mechanism for cross provincial immediate reimbursement of medical insurance in China, so as to provide reference for optimizing the filing mechanism and improving the filing accessibility of insured personnel.Methods:Taking the filing policy of cross provincial immediate reimbursement of medical insurance in 2019 as the research object, on the basis of a comprehensive understanding of the national filing policy background, 90 coordinating regions in Zhejiang Province, Hubei Province and Ningxia Hui Autonomous Region were taken as survey samples to evaluate the relevant policies and extract key parameters, including filing identification methods, filing-related settlement benefits and filing ways. The parameters were compared and analyzed by using descriptive statistical methods.Results:The results of the survey showed that in terms of identity recognition methods, the provision of various supporting materials(residence permit, work certificate, etc.)was still the main way to carry out identity recognition for medical insured persons in different places.Filing-related reimbursement benefits were mainly adjusted by limiting the area of medical insurance treatment and adjusting the benefits parameters(reimbursement ratio). In terms of filing channels, 51(56.7%)sample co-ordination areas had realized at least one remote filing mode.Conclusions:The inclusiveness of filing identity verification mechanism for the floating population needs to be further improved, the filing-related treatment policies need to be further improved, and the convenience and standardization of filing channels need to be strengthened.