Accurate classification of the acetabular injuries and appropriate treatment plan are great challenges for orthopedic surgeons because of the irregular anatomical structure of the acetabulum and aggregation of important vessels and nerves around it. Letournel-Judet classification system has been widely applied to classify acetabular fractures. However, there are several limitations, including incomplete inclusion of fracture types, difficulty in understanding and insufficient guidance for surgical treatment, etc. Serious complications such as traumatic arthritis are common due to wrong classification and diagnosis and improper selection of surgical strategy, which brings a heavy burden to the society and families. Three-column classification, based on anatomic characteristics, has advantages of containing more fracture types and being easy to understand, etc. To solve the problems existing in the diagnosis and treatment process based on Letournel-Judet classification, achieve accurate diagnosis and treatment of patients with acetabular fractures, and obtain satisfactory prognosis, the Orthopedic Trauma Emergency Center of Third Hospital of Hebei Medical University and the Trauma Orthopedic Branch of the Chinese Orthopedic Association organized experts from relevant fields to formulate the Expert consensus on the accurate diagnosis and treatment of acetabular fractures based on three-column classification ( version 2023) in terms of principles of evidence-based medicine. Based on the three-column classification, 15 recommendations were proposed, covering the diagnosis, treatment, complication prevention and management, etc, so as to provide reference for accurate diagnosis and treatment of acetabular fractures.

Objective To retrospectively analyze the effects of nerve block anesthesia versus general anesthesia on intertrochanteric fracture in the elderly. Methods The 104 elderly inpatients undergoing closed reduction and intramedullary nailing for the treatment of femoral intertrochanteric fractures were recruited into this study at Department of Orthopedics ,Xiangya Hospital ,Central South University from January 2015 to June 2017.Medical records were collected and analyzed by SPSS 16.0 or GraphPad Prism 6.0 software. Results A total of 104 patients were divided into general anesthesia group(n= 48 )and nerve block anesthesia group (n= 56 ). There was no statistical difference in the demographic characteristics between the two groups. The changes in heart rate ,maximum changes of systolic/diastolic blood pressures ,and infusion volume during surgery were lower in the nerve block anesthesia group than in the general anesthesia group [(12.7 ± 7.3)vs. (18.1 ± 7.8)beats/min ,(22.5 ± 8.8/12.2 ± 7.5)mmHg vs. (34.3 ± 7.9/21.6 ± 6.6)mmHg ,(792.9 ± 387.0)ml vs. (1 083.0 ± 445.5)ml ,respectively ,t=3.64 ,7.14 ,6.73 ,5.16 ,all P＜0.01]. There was no statistically significant difference between two groups in other perioperative data and the number of deaths at three months and one year after surgery. Conclusions As compared with the general anesthesia ,the nerve block anesthesia has less effects on the heart rate ,less maximum changes of systolic and diastolic blood pressures ,and less infusion volume during surgery ,and has no significant increase in postoperative mortality ,which is safe and worthy of further promotion.

Objective To understand the job burnout status of bank staff and analyse the relationship between job burnout and self-efficacy,job satisfaction.Methods The job burnout,self-efficacy and job satisfaction of 8 942 bank staff was surveyed by Maslach burnout inventory-general survey(MBI-GS),general self-efficacy scale (GSES) and job satisfaction scale (JSS) respectively.Results A total of 8 942 questionnaires were issued and 7 486 valid questionnaires were returned.The score of self-efficacy in male was significantly higher than that in the female(P ＜0.05).There was no significant difference in job satisfaction score between male and female(P ＞ 0.05).The score of emotional exhaustion (EE) in female was significantly higher than that in male,while the score of reduced personal accomplishment(RPA) was significantly lower than that in male (P ＜ 0.05);there was no significant difference in depersonalization (DP) score between male and female (P ＞ 0.05).The EE,DP and PAL scores of bank staff with post-graduate education were significantly lower than those with high school/secondary school and junior college/undergraduate (P ＜ 0.05);the DP and PAL scores of bank staff with junior college/undergraduate were significantly lower than those with high school/secondary school(P ＜ 0.05);there was no significant difference in EE score of bank staff between junior college/undergraduate and high school/secondary school(P ＞ 0.05).The EE score of age ＞ 50 years old bank staff was significantly lower than that of age ＜ 30 years old,30-40 years old and 41-50 years old (P ＜0.05);there was no significant difference in EE score among age ＜30 years old,30-40 years old and 41-50 years old bank staff (P ＞ 0.05).The DP score of 41-50 years old bank staff was significantly higher than that of age ＜ 30 years old (P ＜0.05);there was no significant difference in DP score among age ＜30 years old,30-40 years old and 41-50 years old bank staff (P ＞ 0.05).There was no significant difference in PAL score among all age groups (P ＞ 0.05).The three dimensions of job burnout had significant negative correlation with self-efficacy and job satisfaction (P ＜ 0.05).Conclusion Bank staff have a certain degree of job burnout.Age,sex,and education level maybe the influence factors of job burnout.Improvement of self-efficacy and job satisfaction may help to reduce the job burnout.

Objective To explore the value of comprehensive biochemical and serological test in Salmonella clinical test .Methods A total of 95 cases of suspected salmonella infection with enteric fever were selected as subjects in this study from April 2013 to A‐pril 2014 ,and 48 cases randomly divided in research group ,47 cases in control group .Regular inspection was conducted in the con‐trol group ,comprehensive biochemical and serological test were conducted in the control group .Compared the results in the two groups .Results The salmonella detection rate in the research group was 93 .75% ,which was significant higher than 68 .09% in the control group (P< 0 .05) .Conclusion Combined detection of comprehensive biochemical and serology test could detect Salmonella effectively ,it is worthy of application and popularization in clinic .

Objective To explore a variety of levels of serum marker test applications in the diagnosis of fatty liver .Methods Data were randomly selected from April 2013 to April 2014 for treatment of patients with fatty liver hospital 45 cases ,set the study group ,choose the same period in healthy volunteers to undergo a medical examination in our hospital 45 cases ,it was set to control group ,two groups of subjects were taking a variety of levels of serum markers tested .Comparison and analysis of two groups of subjects to detect a variety of levels of serum markers and positive case detection rate .Results The study group subjects ALT , AST ,TG ,TC index the average level of detection was higher than the control group ,statistically significant differences (P<0 .01);study group subjects ALT ,AST ,TG ,TC index the positive rates were 77 .78% ,93 .33% ,55 .56% ,46 .67% more than 8 .89% in the control group ,4 .44% ,15 .56% ,11 .11% higher ,statistically significant differences (P<0 .05);United biochemical indicator de‐tection of biochemical indicators of detection rate of fatty liver was obviously higher than that of single detection rate ,the difference was statistically significant (P<0 .05) .Conclusion Multiple levels of serum markers of fatty liver diagnostic test in higher detec‐tion rate .

The rapid atrial pacing model is one of the most popular atrial fibrillation animal models. In this paper, a novel implementation of wireless implantable stimulating and ECG monitoring system is described based on the requirements of rapid atrial pacing model. Hardware circuits and software structure of the system are introduced. And test outcomes through in-vitro simulation and in-vivo animal models are presented. After verified by animal tests, the system can be used to initiate and monitor chronic atrial fibriation in real time.
Animals ; Atrial Fibrillation ; diagnosis ; Electrocardiography ; instrumentation ; Heart Atria ; physiopathology ; Models, Animal ; Monitoring, Physiologic ; instrumentation ; Prostheses and Implants ; Software

The rapid atrial pacing model is one of the most popular atrial fibrillation animal models. In this paper, a novel implementation of wireless implantable stimulating and ECG monitoring system is described based on the requirements of rapid atrial pacing model. Hardware circuits and software structure of the system are introduced. And test outcomes through in-vitro simulation and in-vivo animal models are presented. Affter verified by animal tests, the system can be used to initiate and monitor chronic atrialfibriation in real time.

ObjectiveTo evaluate three methods of detecting anti-aquaporin 4 (AQP4) antibody in neuromylitis optica (NMO),including indirect immunofluorescence assay organization(IIF),cell immunofluorescence method (CBA) and ELISA.MethodsThe patients were divided into NMO group (n =29), multiple sclerosis (MS) group (n = 23),and healthy controls group (n = 50).IIF, CBA and ELISA were used in 3 groups to detect serum anti-AQP4 antibody.The sensitivity and specificity as well as the consistency of positive results were compared.ResultsIn the aspect of the sensitivity of the three antiAQP4 antibody to diagnosis NMO, CBA (72.4％) ＞ IIF (62.1％) ＞ ELISA (51.7％) ; in the aspect of specificity, CBA (100.0％) ＞ ELISA (98.6％) ＞ IIF (97.3％).Kappa testing and evaluation method showed that the three detection methods were all in good consistency, particular in CBA and ELISA (P ＜0.01).ConclusionsCBA method showed a highest specificity and sensitivity in all these three anti-AQP4 antibody detection methods.CBA and ELISA are in better consistency of positive results.

Objective To investigate the feature brain damage and clinical manifestations in neuromyelitis optica (NMO) patients; To investigate the relationship between serum NMO-IgG antibody and NMO brain damage. Methods Clinical data of 37 NMO patients and their head and spinal cord MRI by 1.5T superconducting MR scanner, were analyzed; serum NMO-IgG antibody were measured by immunofluorescence. Results 17 cases were found to have abnormal signals on MRI, which were mainly in the white matter, pons, medulla, ventricle, aqueduct, and around the corpus callosum; According to pathological changes, brain damage can be divided into scattered irregularity (13 cases), fusion (3 cases),multiple sclerosis-like (1 case) ,with scattered irregularity more common,5 cases had clinical manifestations of brain damage: somnolence, vomiting, diplopia, visual rotation, 11 cases patients with brainstem damage show positive serum NMO-IgG antibodies. Conclusions Brain damage can be seen in half of NMO patients, they often located in the high expression area of AQP4: brain white matter, periventricular,brainstem and so on. Clinical symptoms has nothing to do with the size of lesions but the location, they often occur when brainstem was involved. Serum NMO-IgG is helpful in differentiating NMO with brain damage and MS.

Objective To explore the clinical outcome of perforator flaps for reconstruction of limb soft tissue defects. Methods In this case series, from 2007 July to 2009 May, 108 cases of perforator flap to reconstruct the defects of the extremities were performed, of these, 98 were free perforator flaps, 10 were pedicled flaps. The perforator flaps included deep inferior epigastric artery perforator flap, anterolateral thigh perforator flap, thoracodorsal artery perforator flap, lateral thigh perforator flap, posterior interosseous artery perforator flap, collateral radial artery perforator flap, medial sural artery perforator flap, posterior tibial artery perforator flap, deep circumflex iliac artery perforator flap and peroneal artery perforator flap. The maximum size of the perforator flap was 44 cmx 9 cm, the minimum size of the perforator flap was 4 em x 2 cm.The donor defect was closed directly. Results Venous congestion occurred in 5 flaps, in 1 case venous congestion was overcomed after released the dressing, 4 flaps requiring reexploration for venous insufficiency,2 had a successful outcome, the other 2 flaps failed . The other 103 flaps were successful. The wounds healed without any infection complications. The follow-up ranges from 6-24 months( 10 months on average). The flaps were of good appearance and not bulky; there were only linear scars on the donor sites, the cosmesis and function of the donor sites were satisfying. Conclusion The muscle, deep fascia and motor nerve are not contained in the flap, the advantages of this type of flap is reducing morbidity of the donor site and its reliable blood supply and suitable thickness for resurfacing, no secondary debuiking is necessary. The perforator flaps can be chosen as the first option to deal with superficial extremity wounds.