Objective Exploring the clinical efficacy of using autologous rib cartilage grafting to reconstruct finger hemiarticular defects.Methods From August 2022 to February 2024,for 6 patients with hemiarticular surface defects in the metacarpophalangeal joints and interphalangeal joints of 8 fingers,costal cartilage was used for joint remodeling and transplantation to reconstruct the hemiarticular surface defects of the fingers.All 8 joint transplants in 6 patients were two-stage surgeries.In the first stage,antibiotic bone cement was used to fill the space-occupying lesions,and in the second stage,costal cartilage joint remodeling was performed to reconstruct the finger joint defects.Postoperative follow-up and assessment of fracture healing according to Paley fracture healing scoring criteria.Outpatient and WeChat follow-up,upper limb function is evaluated according to the upper limb functional assessment standards of the Chinese Medical Association Hand Surgery Society.Record VAS pain score.Results In this group,there were a total of 6 patients with 8 cases of hemiarticular defects.Among them,2 patients had two joint surgical sites,while the remaining 4 patients had a single joint surgical site.There were 2 cases of metacarpophalangeal joint head defects,2 cases of proximal articular surface defects,3 cases of proximal articular head defects,and 1 case of thumb proximal articular head defect.After surgery,8 out of 6 patients'hand wounds healed successfully.All patients were followed up for 6-12 months postoperatively,with an average of 9 months.The VAS pain score(affected finger)for the last follow-up was 0-2 points,with an average of 0.6 points.According to Paley's scoring criteria,all 6 patients had excellent fracture healing.According to the evaluation criteria for upper limb functional assessment of the Chinese Medical Association Hand Surgery Society,3 cases were rated as excellent,3 cases were rated as good,and 2 cases were rated as fair.Conclusion For patients with half joint defects on one side of the finger,rib rib cartilage was used for joint reconstruction,which significantly improved the joint shape and function at the defect site,and reduced joint pain scores.

Objective Exploring the clinical efficacy of using autologous rib cartilage grafting to reconstruct finger hemiarticular defects.Methods From August 2022 to February 2024,for 6 patients with hemiarticular surface defects in the metacarpophalangeal joints and interphalangeal joints of 8 fingers,costal cartilage was used for joint remodeling and transplantation to reconstruct the hemiarticular surface defects of the fingers.All 8 joint transplants in 6 patients were two-stage surgeries.In the first stage,antibiotic bone cement was used to fill the space-occupying lesions,and in the second stage,costal cartilage joint remodeling was performed to reconstruct the finger joint defects.Postoperative follow-up and assessment of fracture healing according to Paley fracture healing scoring criteria.Outpatient and WeChat follow-up,upper limb function is evaluated according to the upper limb functional assessment standards of the Chinese Medical Association Hand Surgery Society.Record VAS pain score.Results In this group,there were a total of 6 patients with 8 cases of hemiarticular defects.Among them,2 patients had two joint surgical sites,while the remaining 4 patients had a single joint surgical site.There were 2 cases of metacarpophalangeal joint head defects,2 cases of proximal articular surface defects,3 cases of proximal articular head defects,and 1 case of thumb proximal articular head defect.After surgery,8 out of 6 patients'hand wounds healed successfully.All patients were followed up for 6-12 months postoperatively,with an average of 9 months.The VAS pain score(affected finger)for the last follow-up was 0-2 points,with an average of 0.6 points.According to Paley's scoring criteria,all 6 patients had excellent fracture healing.According to the evaluation criteria for upper limb functional assessment of the Chinese Medical Association Hand Surgery Society,3 cases were rated as excellent,3 cases were rated as good,and 2 cases were rated as fair.Conclusion For patients with half joint defects on one side of the finger,rib rib cartilage was used for joint reconstruction,which significantly improved the joint shape and function at the defect site,and reduced joint pain scores.

Objective:To explore the short-term efficacy on 3D printing assisted reconstruction of traumatic digit joint defects using rib and costo-osteochondral autograft.Methods:From August 2022 to July 2023, 7 patients with open digit joint defects had undergone emergency primary debridement and fracture fixation in the Department of Orthopaedics, 988th Hospital of the Joint Logistics Support Force of PLA. Patients with more phalangeal defects that could not be aligned were treated with antibiotic bone cement filling in the emergency surgery. In the second stage surgery, bone cement was removed and transfer of rib cartilage graft was performed to reconstruct the digit joint defect. According to a 1∶1 3D printed hand templates, rib cartilage grafts were crafted to the shape of digit joints, and then spliced together the digit joints and bone defects for fixation. Follow-up X-ray examinations were taken and assessment of the healing status of rib and fractures of phalangeal and metacarpophalangeal bones were carried out according to the Paley fracture healing score. At the outpatient follow-up, assessment of transferred joint movement and evaluation of upper limb function were conducted according to the Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association. Visual Analogue Scale (VAS) pain scores were evaluated from the affected digits and donor sites.Results:After reconstructive surgery, all 7 patients had primary healing of the wounds of hand. One patient had fat liquefaction at the donor site, and the rest had primary donor site healing. One patient received further surgery for extensor tendon repair after rib cartilage grafting due to the digital extensor tendon injury. All 7 patients were included in postoperative follow-up for 6-11 months, with an average of 9 months. All patients had excellent fracture healing according to the Paley fracture healing score. At the final follow-up, the extension and flexion of the digit joints were found at 40°-80° (average 56.2°) for proximal interphalangeal joints (4 patients), and 10° in extension and 85° in flexion for metacarpophalangeal joint (1 patient). The range of motion of the thumb interphalangeal joint (2 patients) was 20°-35° (average 27.5°). Hand function was assessed according to Evaluation Trial Standards of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association and it was found that 3 patients were in excellent, 3 in good and 1 in fair.Conclusion:This study focused on the treatment of traumatic digit joint defects by transfer of individually crafted rib cartilages in reconstruction of the defected digit joint. It significantly improves the appearance and function of the defected digit joints, especially suitable for the irregular defects of phalangeal bones.

Objective To design reasonable informatization model of nursing human resource allocation and to apply it to clinical nursing so as to make nursing human resource allocation scientific and reasonable.Methods The time table was designed according to the program of direct nursing and indirect nursing. It was tested in five surgical departments between January 19th 2016 and January 23rd 2016 and five internal medicine between January 24th 2016 and January 28th 2016. The situation before and after allocation were compared with the questionnaires of quality of nursing, patients' satisfaction and nurses' satisfaction. Results The nursing human resource allocation model built with information technology could export the hours of direct nursing in real time and configure nursing staff reasonably in line with the hours of nursing. The quality of nursing, patients' satisfaction and nurses' job satisfaction after the reasonable allocation were higher than those before allocation with statistically significant differences (t=-29.646, -5.783, -2.369;P<0.05). Conclusions The nursing human resource allocation designed by the research is with real time. Besides, it can improve the quality of nursing, patients' satisfaction and nurses' job satisfaction.

BACKGROUND:Silk fibroin as natural biological macromolecules has good biocompatibility, but it is difficult to make the three-dimensional scaffold with uniform structure because of its higher crystalization performance and bigger brittleness. OBJECTIVE:To improve the crystalization of silk fibroin through the addition of chitosan, and to get three-dimensional tissue engineering scaffolds with better mechanical strength. METHODS: CaCl2/CH3CH2OH/H2 RESULTS AND CONCLUSION:The introduction of chitosan could improve the properties of scaffolds. The porosity of the composite scaffold with lower porosity was more uniform and orderly with higher content of O ternary solution was used to dissolve silkworm cocoon to extract silk fibroin and form solution. Silk fibroin solution and chitosan solution were mixed according to different mixing ratios of 2:1, 1:1, 1:2, respectively, and then porous silk protein/chitosan scaffolds were prepared by freeze-drying method and treated by methanol. Scaffold morphology was observed by scanning electron microscopy, the chemical structure and crystaline state of the scaffolds were characterized through infrared spectrum and X-ray diffraction test, respectively. Also, the porosity and water uptake were tested and periodic cycle compression mechanical properties under the water environment were determined. chitosan. When the mixture rate of chitosan and silk fibroin was 1:2, the water uptake rate was the highest in the composite scaffolds, and also higher than that of the silk fibroin scaffold but lower than that of the chitosan scaffold. With the increase of silk fibroin, the composite scaffolds had better elasticity and stronger ability to maintain the shape.

AIM: To evaluate the therapeutic effect and safety of the rifamycin sodium injection (SV) in treatment of patients with pulmonary tuberculosis. METHODS: 44 cases of pulmonary tuberculosis were randomly allocated to two groups: rifamycin sodium group and routine treatment group. Chemotherapy regimens: in the rifamycin sodium group, 21 cases were treated with the regimen of 2HZE+SV/7HR; and in the routine treatment group, 23 cases were treated with the regimen of 2HRZE/7HR. RESULTS: The sputum negative conversion rate of the rifamycin sodium group was 85.7 %, and the foci vanishing rate was 90.5 %, while the both rates in the routine treatment group were 60.9 % and 60.9 %, respectively. There was significant difference between the two groups (P