Objective To evaluate the clinical application of open reduction and internal fixation and bone grafting on treatment of pilon fractures of tibia.Methods Forty cases with Pilon fractures of Ⅱ,Ⅲ tibia who underwent open reduction and intemalfixation and bone grafting treatment were selected as our subjects.Those 40 cases were performed follow-up for 8.0-60.0 months,and average was 31.5 months.The ankle joint symptoms and functional Mazur scoring system were used to evaluate the function of ankle joint.Results Of the 40 patients,15 cases were with excellent ankle function,and 19 cases were good,4 cases were poor and 2 cases were worse.The excellent and good rate was 85％ (34/40).Conclusion Open reduction and internal fixation and bone grafting is proved as the effective treatment on Ⅱ,Ⅲ tibia pilon fractures.

Hepatopulmonary syndrome is a pulmonary syndrome that is characterized by the clinical triad of chronic liver disease,arteriovenous shunts due to intrapulmonary vasodilatation,and arterial hypoxemia.Dwing to its complicated pathogenisis,unconspicuous behavior and lack of clinic features,it is very hard for early diagnosis,so while diagnosed,most of HPS patients are in a hard way.The clinical treatment is limited with unsatisfactory effectiveness,so does the prognosis.This article reviews the current diagnosis and therapies of hepatopulmonary syndrome.

Objective To investigate surgical outcomes of treatment of pilon fractures of Ruedi -Allgower types Ⅱ and Ⅲ by raft screws fixation combined with bone grafting.Methods 21 patients with pilon fractures of Ruedi -Allgower types II and Ⅲ received surgery were selected.They were 15 men and 6 women,23 to 68 years of age(average 38.2 years).16 cases were closed and 5 cases open.12 cases were type II and 9 cases type III.Intervals between injury and operation ranged from 7 to 14 days,with 8.5 days on average.All of them were treated with raft screws fixation by plate type L combined with bone grafting.Results All cases were followed up for an average of 12 months(range from 8 to 30 months).Fractures healed from 16 to 24 weeks,with 18.2 weeks on average.According to the Burwell -Charnley radiological criteria,anatomical reduction was achieved in 17 cases,and fair reduction in 4.According to the Mazur clinical criteria,ankle functions were rated as excellent in 8 cases,good in 10 cases,fair in 2 cases and poor in 1 case.The rate of excellent and good was 85.7%.Conclusion Raft screws fixation combined with bone grafting are effective for the pilon fractures of Ruedi -Allgower types II and Ⅲ,preventing articular surface collapse and leading to anatomic reduction,and has stable fixation and early functional rehabilitation.

Objective To study the guiding role of ultrasonography to the operation of spontaneous constriction of radial nerve.Methods Six patients with spontaneous constriction of radial nerve were checked by ultrasound before operation to identify the number,position and morphological change of the constriction lesions of the radial nerve.The result was compared with the operation result.Results According to the ultrasonography results,2 to 3 constriction lesions were found on the radial nerve of all the 6 patients.The ultrasonography description of the number,position and morphological change of the lesions was consistent with the operation result.After the operation,the radial nerve function of all the patients got recovered.Conclusions Ultrasonography examination before operation can identify the number,position and morphological change of the constriction lesions of the radial nerve,which has great value when planning the operation.

Objective To study the homology characteristics of clinicaly isolated and colonized linezolid(LZD)-resistant Enterococcus faecalis (E.faecalis) strains from a patient.Methods Ten E.faecalis strains (2 were isolated from urine specimens and 8 were from stool specimens) isolated from a patient with pulmonary infection were performed antimicrobial susceptibility testing, homology of E.faecalis was determined by pulsed-field gel electrophoresis (PFGE).Results Before and after patients received LZD therapy, 2 E.faecalis strains isolated form urine specimens were both resistant to LZD (MICs: 8 mg/mL, 16 mg/mL, respectively), among 8 strains from stool specimens (6 were isolated before therapy, and 2 were isolated after therapy), LZD susceptible, intermediate, and resistant strains were 4, 2, and 2 respectively(MICs: 0.25-12 mg/mL).10 strains of E.faecalis were homologous by PFGE typing.Conclusion In this case, the detection of E.faecalis from urinary tract and intestinal tract is homologous, which suggested that LZD-resistant Enterococcus may be colonized in vivo for a long time, and may be shift to cause bacterial infection.

In this study, retrospective multi-center study on medical records of Uyghur medicine diagnosis and treatment program of osteoporosis was done and demographic, diagnostic, therapeutic, efficacy evaluation and nursing data and other information were collected. The main and secondary disease manifestations of osteoporosis were analyzed inductively. Osteoporosis was divided into 2 types in Uyghur medicine field, which were abnormal Savda type and abnormal Balgham type. Uighur medicine syndrome type standards of osteoporosis were established. Treatment efficacy was evaluated according to bone pain, bone density, life quality, and improvement of clinical symptoms and Uyghur medical symptoms. On this basis, in accordance with the technical requirements of the national drug review, the study developed clinical research guidelines for the treatment of osteoporosis with new Uyghur medicine (draft).

The medical assistance to advanced schistosomiasis patients established by the Chinese government is a major public facility for patients with advanced schistosomiasis. Since the medical assistance to advance schistosomiasis patients in Hu?nan Province started ten years ago,a set of mature and operable programs with whole program management and related technolo?gies has been developed. The author investigated the data on medical assistance to advanced schistosomiasis patients in Hunan Province during the last 10 years(from 2006 to 2015)retrospectively,and found that the program had high therapeutic effect and high satisfaction degree of both patients and the society. In order to improve the management of the medical assistance to ad?vanced schistosomiasis patients and share our experiences of the whole program management and related technologies with the colleagues of other provinces,this paper mainly illustrates the experiences of the program,as well as the existing problems and related strategies.

This paper summarizes the clinical diagnosis and treatment of imported African schistosomiasis,in order to make the therapeutic standards. Imported African schistosomiasis includes mainly schistosomiasis haematobia and schistosomiasis mansoni in China. In order to set up the operational standards,enhance diagnostic and cure rates,and reduce the complica?tions,we review the related literature combined with our experience over years,and summarize,in this paper,the pathogenic mechanism,and key points of clinical diagnosis and treatment of schistosomiasis haematobia and schistosomiasis mansoni,so as to provide the reference for clinical doctors.

Objective To analyze fungal isolates from patients with superficial fungal infections during 1960-2006.Methods Fungal strains isolated from patients with superficial (mucocutaneous and cutaneous)fungal infections and identified in the Medical Mycology Clinical Laboratory,Department of Dermatology and Venereology,Union Hospital,from 1960 to 2006 (data from September 1991 to July 1992 were unavailable),were subjected to a classification and statistical analysis.Clinical samples for mycological examination were taken from outpatients or inpatients of different departments in hospitals of Hubei province and surrounding areas.Morphological,physiological and biochemical methods were applied for species identification.Results A total of 11 989 Candida strains were isolated,which belonged to 23 species and 16 genera.They fell into 3 groups,i.e.,dermatophytes,Candida and yeasts (including Malassezia),and non-dermatophyte moulds.Since 287 strains of moulds were suspected to be contaminating fungi,11 702 residual isolates were analyzed.Of the analyzed isolates,Candida species (5642/11 702,48.2％ )and dermatophytes (5279/11 702,45.1％ )predominated,followed by yeasts (449/11 702,3.8％) and Malassezia species (332/11 702,2.8％).The most frequently isolated species was Trichophyton rubrum (3865/11 702,33.0％),Candida albicans (3110/11 702,26.6％ ) and non-albicans Candida species (2532/11 702,21.6％ ).Dermatophyte strains were mostly isolated from lesions of smooth skin with an exception of palmoplantar and interdigit regions (1787/5279,37.7％).The most common dermatophyte species was Trichophyton rubrum,followed by Trichophyton violanceum.Candida was mainly isolated from mucous membrane lesions (4099/5642,72.7％),with Candida albicans being the predominant species.Conclusions Candida species and dermatophytes predominate in patients with superficial fungal infections during 1960-2006,with Trichophyton rubrum being the most common species.

Objective:To examine the clinical effect of early administration of Shakubatracvalsartan following early percutaneous coronary intervention(PCI)in patients diagnosed with acute myocardial infarction and acute heart failure.Methods:This study prospectively included 65 patients with acute myocardial infarction and acute heart failure who were admitted to the First People's Hospital of Shangqiu from June 2018 to October 2022.The patients were randomly divided into two groups: the control group(35 cases)and the observation group(30 cases).Both groups received early PCI treatment.After the operation, the control group received oral administration of Benazepril hydrochloride, while the observation group received oral administration of Shakubatracvalsartan for a duration of 8 weeks.The study compared the total treatment efficiency and cardiac function parameters, such as left ventricular ejection fraction(LVEF), left ventricular end-diastolic diameter(LVEDD), and clear brain natriuretic peptide precursor(NT-proBNP)as well as myocardial injury markers(creatine kinase isoenzyme MB(CK-MB)and myoglobin(Myo))before and at 8 weeks of treatment between the two groups.Additionally, any adverse effects that occurred during the treatment period were also compared.Results:The total effective rate was 93.33%(28 cases)in the observation group and 71.43%(25 cases)in the control group.The observation group had a higher rate compared to the control group, and this difference was statistically significant( χ2=5.149, P<0.05).Both groups showed an increase in left ventricular ejection fraction, a decrease in left ventricular end-diastolic diameter, and a decrease in N-terminal pro-brain natriuretic peptide.In the observation group, the left ventricular ejection fraction was(48.52±3.28)%, which was higher than the control group's(43.86±2.52)%, and the left ventricular end-diastolic diameter was(46.70±2.88)mm and the N-terminal pro-brain natriuretic peptide was(680.44±87.04)pg/L, which were lower than the control group's(50.46±3.47)mm and(1 715.94±115.41)pg/L, respectively.These differences were statistically significant( t=13.434, 5.287, 5.330, P<0.05 for all).The levels of creatine kinase-MB and myoglobin in both groups were significantly lower after treatment.Specifically, the observation group had levels of(31.42±5.76)U/L and(34.42±5.36)mg/L, which were lower than the levels in the control group of(38.44±4.94)U/L and(43.15±7.46)mg/L.These differences were statistically significant( t=5.287, 5.330, P<0.05 for all).The readmission rate was 10.00%(3 cases)in the observation group and 14.29%(5 cases)in the control group.The readmission rate of the observation group was lower than that of the control group, and the difference was not statistically significant( χ2=0.021, P>0.05). Conclusions:The early administration of Shakubatracvalsartan following early PCI has been shown to effectively enhance cardiac function in patients with acute myocardial infarction and acute heart failure.It also facilitates the repair of myocardial cells and improves the therapeutic outcomes after surgery.