Objective:To compare the efficacy of Ilizarov ring external fixation and unilateral rail external fixation in the treatment of infected bone defects following surgery for tibial fractures.Methods:A retrospective cohort study was conducted to analyze the clinical data of 50 patients with infected bone defects after surgery for tibial fractures, who were admitted to the 940th Hospital of the Joint Logistics Support Force of the PLA from August 2019 to November 2021, including 37 males and 13 females, aged 19-59 years [(42.2±8.8)years]. After debridement and osteotomy, 28 patients were treated with Ilizarov ring external fixation (Ilizarov group) and 22 with unilateral rail external fixation (unilateral fixation group). All the patients in the two groups had previously undergone internal fixation with plates or Kirschner wires for tibial fracture before bone transport. Bone transport started at one week for three stages after successful infection control and osteotomy and was conducted. The following parameters were compared between the two groups: frame-wearing time and healing index after bone transport, self-rating anxiety scale (SAS) grade at 6 months after bone transport, Paley score and Association for the Study and Application of the Method of Ilizarov (ASAMI) score at the last follow-up, Hospital for Special Surgery (HSS) knee score and Baird-Jackson ankle score on admission, after external fixator removal and at the last follow-up, and incidence of postoperative complications.Results:All the patients were followed up for 28-36 months [(32.5±1.6)months]. There were no significant differences in frame-wearing time or healing index between the two groups after bone transport ( P>0.05). At 6 months after bone transport, the SAS grade in the unilateral fixation group (13 patients with mild anxiety, 8 with moderate anxiety, and 1 with severe anxiety) was better than that in the Ilizarov group (6 patients with mild anxiety, 19 with moderate anxiety, 3 with severe anxiety) ( P<0.01). No significant differences were found in the Paley score or ASAMI score between the two groups at the last follow-up ( P>0.05). There were no significant differences in HSS knee score or Baird-Jackson ankle score between the two groups on admission, after external fixator removal or at the last follow-up ( P>0.05). No significant differences were observed in the incidence of pin tract infection, poor healing, infection in the bone elongation area, or re-fracture between the two groups ( P>0.05). The incidence of postoperative axial deviation was 0 in the Ilizarov group, lower than 18% in the unilateral fixation group (4/22) ( P<0.05). Conclusion:Although Ilizarov ring external fixation and unilateral rail external fixation demonstrate comparable efficacy in the treatment of infected bone defects after surgery for tibial fractures, the former provides superior mechanical stability and postoperative axial deviation correction, while the latter offers advantages in reducing psychological burden and enhancing treatment tolerance.

Objective:To compare the efficacy of Ilizarov ring external fixation and unilateral rail external fixation in the treatment of infected bone defects following surgery for tibial fractures.Methods:A retrospective cohort study was conducted to analyze the clinical data of 50 patients with infected bone defects after surgery for tibial fractures, who were admitted to the 940th Hospital of the Joint Logistics Support Force of the PLA from August 2019 to November 2021, including 37 males and 13 females, aged 19-59 years [(42.2±8.8)years]. After debridement and osteotomy, 28 patients were treated with Ilizarov ring external fixation (Ilizarov group) and 22 with unilateral rail external fixation (unilateral fixation group). All the patients in the two groups had previously undergone internal fixation with plates or Kirschner wires for tibial fracture before bone transport. Bone transport started at one week for three stages after successful infection control and osteotomy and was conducted. The following parameters were compared between the two groups: frame-wearing time and healing index after bone transport, self-rating anxiety scale (SAS) grade at 6 months after bone transport, Paley score and Association for the Study and Application of the Method of Ilizarov (ASAMI) score at the last follow-up, Hospital for Special Surgery (HSS) knee score and Baird-Jackson ankle score on admission, after external fixator removal and at the last follow-up, and incidence of postoperative complications.Results:All the patients were followed up for 28-36 months [(32.5±1.6)months]. There were no significant differences in frame-wearing time or healing index between the two groups after bone transport ( P>0.05). At 6 months after bone transport, the SAS grade in the unilateral fixation group (13 patients with mild anxiety, 8 with moderate anxiety, and 1 with severe anxiety) was better than that in the Ilizarov group (6 patients with mild anxiety, 19 with moderate anxiety, 3 with severe anxiety) ( P<0.01). No significant differences were found in the Paley score or ASAMI score between the two groups at the last follow-up ( P>0.05). There were no significant differences in HSS knee score or Baird-Jackson ankle score between the two groups on admission, after external fixator removal or at the last follow-up ( P>0.05). No significant differences were observed in the incidence of pin tract infection, poor healing, infection in the bone elongation area, or re-fracture between the two groups ( P>0.05). The incidence of postoperative axial deviation was 0 in the Ilizarov group, lower than 18% in the unilateral fixation group (4/22) ( P<0.05). Conclusion:Although Ilizarov ring external fixation and unilateral rail external fixation demonstrate comparable efficacy in the treatment of infected bone defects after surgery for tibial fractures, the former provides superior mechanical stability and postoperative axial deviation correction, while the latter offers advantages in reducing psychological burden and enhancing treatment tolerance.

Objective To understand the epidemic status of biological stings on an island and the knowledge about environmental emergencies of personnel stationed on the island.Methods With convenience sampling,we investigated 270 personnel using a self-designed anonymous questionnaire based on clinical treatment situation and on-the-spot investigation of the island.Results A total of 270 questionnaires were distributed,and 254 valid questionnaires were returned,with an effective rate of 94.07％.A total of 164(64.57％)personnel had a history of stings,with median times of 2(0,5).The main clinical symptoms were local swelling and pain(142 cases,86.59％)and pruritus(110 cases,67.07％).The personnel scored 14(11,17)for the first aid knowledge about island environmental emergencies(the full score was 26).The vast majority of personnel(227 cases,89.37％)believed that it was necessary to learn the knowledge about island environmental emergencies,and the majority of personnel(186 cases,73.23％)hoped to learn through centralized teaching.Conclusion The environmental emergencies represented by biological stings are becoming increasingly serious,so it is necessary to carry out multiple prevention and environmental control measures,and to carry out regular and long-term training for personnel stationed on islands.

Objective To investigate the prognostic value of serum adenosine deaminase(ADA)and plas-minogen activator inhibitor 1(SERPINE1)levels in patients with type 2 diabetes mellitus(T2DM)complicat-ed with acute cerebral infarction(ACI).Methods A total of 195 patients with T2DM combined with ACI(ACI group)and 174 patients with T2DM alone(control group)admitted to Xi'an Labor Union Hospital from March 2019 to March 2023 were selected.The levels of serum ADA and SERPINE1 were compared be-tween ACI group and control group,and patients with different degrees of neurological defect and prognosis.The influencing factors of poor prognosis in T2DM patients with ACI were analyzed,and the value of each in-dex in predicting poor prognosis was evaluated.Results The levels of ADA and SERPINE1 in ACI group were significantly higher than those in control group(P＜0.05).With the aggravation of neurological deficit in T2DM patients with ACI,serum ADA and SERPINE1 levels increased(P＜0.05).The levels of serum ADA and SERPINE1 in the poor prognosis group were higher than those in the good prognosis group(P＜0.05).Severe neurological deficit and high levels of ADA,SERPINE1 and HbA1c were risk factors for poor prognosis in T2DM patients with ACI(P＜0.05).The area under the curve(AUC)of ADA combined with SERPINE1 for predicting the prognosis of T2DM patients with ACI was 0.896,which was higher than that of Ada and SERPINE1 alone(P＜0.05).Conclusion Elevated serum ADA and SERPINE1 levels are associated with severe neurological deficits and poor prognosis in T2DM patients with ACI.Combined detection of ADA and SERPINE1 can predict poor prognosis in T2DM patients with ACI.

Surgical minimally invasive techniques such as image intervention, laparoscopy, endoscopy, and assisted medical robotics have become the mainstream of minimally invasive surgery (MIS). However, the vague concept, diverse misunderstanding, and the lack of standards have led to a lot of malpractice in current MIS. Based on the analysis of the clinical situation and the domestic and foreign literatures, the authors have put forward the theory of comprehensive minimally invasive surgery (CMIS), and established the concepts of minimally invasive prevention, minimally invasive diagnosis and minimally invasive follow-up in the view of hepatobiliary surgery. The authors have proposed "three-All" principles of all personnel, all aspects and all processes, and established a comprehensive four-level criteria of outcomes, complications, time and costs for CMIS, in an attempt to provide feasible and practical concepts and standards for MIS from a clinical practice and theoretical level, with a view to standardizing minimally invasive procedures and solving the problem of MIS.

AIM: To compare brucine with the mixed solution of brucine and nano-liposomes to observe analgesic and anti-inflammatory effects of the brucine nano-liposome for local use on skin were studied. METHODS: The effects of brucine,brucine and nano-liposomes mixed solution,brucine nano-liposome,on the edema of mouse ear induced by dimethylbenzene and the writhing induced by acetic acid were investigated. RESULTS: The results showed that brucine nano-liposomes exhibited better anti-inflammatory and analgesic activities than the brucine.(P