Objective:To observe the short-term efficacy of massaging quadriceps on knee osteoarthritis (KOA).
Methods:Totally 30 KOA patients were enrolled and treated mainly with massaging quadriceps, 20 min for each session, once a day, 2 weeks as a treatment course, and for 2 courses in total. After treatment, the changes of visual analogue scale (VAS) and Western Ontario and McMaster Universities osteoarthritis index (WOMAC) were observed.
Result:The VAS and WOMAC scores dropped after treatment, with a statistically significant difference (P<0.01). After a course of treatment, the recovery rate was 33.3% and the total effective rate was 86.7%; after 2 courses, the recovery rate was 60.0% and the total effect rate was 96.7%.
Conclusion:Massaging quadriceps can alleviate pain, improve the function of knee joint, and produce a significant short-term efficacy in treating KOA.

Objective To explore the application of case based learning(CBL)combined with multimedia teaching in the clinical pediatric surgery.Methods 144 five-year program students of Pediatrics in grade 2009 were randomly and evenly divided into the experimental group using CBL with multimedia teaching,and the control group using multimedia teaching mode.After the end of the course the students of the two groups took clinical teaching knowledge test.The evaluation scores were shown by mean ± standard deviation and comparison was made between the two groups with t test.At the same time,teaching satisfaction survey was conducted among the students of the experimental group.Results The usual results,the theoretical scores and total scores of the students in the experimental group were higher than those of the control group students in the operation skills,clinical thinking,and there was statistically significant difference in P＜0.01.(P=0.003,P=0.002,P=0.008,P=0.009,P=0.008).The questionnaire survey shows that compared with traditional multimedia teaching,CBL combined with multimedia teaching can preferably culture students' various abilities and is beneficial to learning.Condusion The use of CBL combined with multimedia teaching can affirmatively improve the clinical teaching effect in the clinical pediatric surgery,and it deserves to be generalized in the future teaching.

Objective To study the safety and efficacy of fast track program in anorectal surgery perioperative period. Methods One hundred and sixty-nine cases of rectal cancer were divided into the study group of 86 patients with fast track program, and the control group of 83 patients with traditional programs by random digits table. Both groups were compared from the time out of bed, the first intestinal discharge time,intravenous fluids stopping time,length of hospital stay,total cost of treatment and the incidence of postoperative complications. Results The study group compared with the control group: the first intestinal discharge time [(33.6 ± 12.9) h vs. (81.7 ± 20.1) h], intravenous fluids stopping time [(4.5 ±1.3) d vs.(7.4 ± 1.6) d],and length of hospital stay [(5.6 ± 1.2) d vs.(8.9 ±2.7) d],the total cost of treatment [(15 000 ± 3000) yuan vs. (16 000 ± 4000) yuan], the differences were statistically significant (P ＜ 0.01 or ＜ 0.05),and had less incidence of postoperative complications in study group than that in control group [5.8% (5/86) vs. 16.9% (14/83)], the difference was statistically significant (P ＜ 0.05).Conclusions Fast track program in anorectal surgery perioperative period is safe and effective, beneficial,conducive to rehabilitation of patients.

Objective To compare the effect of titanium elastic nailing (TEN) and plating in treatment of both radius and ulna fractures in children older than 10 years.Methods This retrospective analysis comprised 38 children (50 sides) of both radius and ulna fractures treated with TEN (30sides) or plate (20 sides) between 2009 and 2014.Parameters compared between the two fixation methods were operation time,ratio of open/close reduction,time to internal fixation removal,incidence of postoperative complications,and bone union time.Anderson score was used to evaluate the treatment results.Results Operation time [(94.3 ± 39.5) min vs (120.5 ± 45.4) min],time to internal fixation removal [(210.8 ± 84.1) d vs (264.4 ± 88.9) d],and ratio of open/close reduction (20/10 vs 20/0)varied significantly between TEN and plating groups (P ＜ 0.05 or 0.01).Whereas,no statistically significant differences were noted in regard to complication rate,bone union time,and effect evaluation.Conclusion For fracture of the radius and ulna in children older than 10 years,TEN should be used for closed type without obvious displacement,but plate fixation is associated with lower incidence of fracture malunion and better outcome in treatment of open type with obvious displacement.

Objective To investigate the clinical efficacy of open reduction and internal fixation with K-wires for old Gartland Ⅲ supracondylar fracture in children.Methods A retrospective case series study was conducted on 49 children with old Gartland Ⅲ supracondylar humeral fracture admitted from June 2012 to January 2017.There were 35 boys and 14 girls,with average age of 6.1 years (range,3.4-11.5 years).The duration from initial trauma to operation ranged from 22 days to 60 days (mean,29.8 days).There were five cases of radial nerve injury,one case of median nerve injury,and one case of Volkmann ischemic contracture.All patients were surgically treated with open reduction and internal fixation with K-wires + plaster external fixation.Six patients with nerve injury underwent neurological exploration and release.Nerve partial fracture was seen in one patient during operation,and nerve repair was performed.The fracture healing and complications were observed.At the final follow up,Flynn's criteria was applied to evaluate the elbow joint function.The humerus length and transverse diameter of humeral condyle between the healthy limb and the suffered one were compared to evaluate the humerus growth.Results All patients were followed up for 6-24 months,with an average of 12.5 months.All fractures were healed,with no fracture redisplacement or bone nonunion occurred.The neurological symptoms of six patients with nerve injury disappeared after two months.One patient had superficial skin infection at the incision and recovered after treatment.Six patients (12％) developed cubitus varus deformity after operation.At the final follow-up,the clinical and radiographic outcomes were assessed via Flynn's criteria,and the results were excellent in 37 patients,good in five,fair in one,and poor in six patients,with an excellent and good rate of 86％.There were no significant differences in the humerus length [(189.3 ± 27.8) mm vs.(190.6 ± 28.8) mm] and transverse diameter of humeral condylar [(29.5 ± 3.5) mm vs.(29.7 ± 3.6) mm] (P ＞ 0.05) between the healthy limb and the suffered one,respectively.Conclusion For old Gartland type Ⅲ supracondylar humeral fracture in children,open reduction and internal fixation with K-wires + plaster external fixation can attain satisfactory function recovery of elbow joint and reduce the incidence of cubitus varus deformity,without negative influence on children's humerus growth or development.

Objective:To study the application of establishing WeChat group combined with PBL teaching mode in the practice of pediatric orthopaedics.Methods:The study was conducted among 36 postgraduates of "5+3" pediatrics and 22 postgraduates of orthopedic surgery of Batch 2012 who had practice in Department of Orthopaedics, Children's Hospital of Chongqing Medical University from September 2018 to August 2019, and they were randomized into control group and experimental group, with 29 students in each group. The control group was taught by traditional PBL mode, while the experimental group was taught by WeChat group combined with PBL mode. At the time of leaving the department, the two groups were assessed by theoretical knowledge, practical operation and questionnaire satisfaction, thus evaluating the teaching effects. The SPSS 23.0 was used to conduct t test and chi-square test. Results:The average scores of theoretical knowledge test (91.28±2.89) and practical operation test (87.44±2.94) in the experimental group were significantly higher than those in the control group (87.39±3.53) and (79.06±3.84), with statistically significant differences ( P<0.05). In the survey of teaching satisfaction, the experimental group[96.55%(27/29)] was significantly higher than the control group[61.90%(21/29)], with statistically significant differences ( P<0.05). Conclusion:The establishment of WeChat group and the combination of PBL teaching model can significantly improve the teaching effect and students' satisfaction in the practice of pediatric orthopaedics, which is worthy of further promotion and application.