Tibial plateau fracture is a fracture involving the proximal articular surface of the tibia, and its injury mechanism is complex, the fracture morphology is different, and it is often accompanied by different degrees of soft tissue injury, which is difficult to diagnose and treat. In recent years, the research hotspot has focused on solving the reduction and fixation of the posterior lateral column of the tibial plateau, because it has been clinically found that the residual sagittal plane after tibial plateau fracture is insufficient reduction or loss of reduction leads to knee joint dysfunction. The posterior inclination angle of the tibial plateau is an important parameter to describe the sagittal alignment of the tibia. In the natural state, the posterior tibial slope(PTS) is altered to involve the soft tissues around the knee joint such as anterior cruciate ligament(ACL) and posterior cruciate ligament(PCL), which affects the stability of the knee joint. In total knee arthroplasty(TKA), choosing the appropriate PTS can effectively increase the prosthesis survival rate, improve the flexion and extension knee efficacy, which is beneficial to knee joint stability. In the field of orthopedic trauma, correction of sagittal deformity is equally important, following the principle of "reverse mechanism of injury". Quantitative evaluation of postoperative sagittal realignment of tibial plateau fractures and investigation of the effect of sagittal realignment on long-term outcomes and complications are still poorly understood and require further clinical and biomechanical studies.
Humans ; Tibial Fractures/physiopathology* ; Fracture Fixation, Internal/methods* ; Tibial Plateau Fractures

OBJECTIVE: To analyze the clinical efficacy of manual reduction combined with 3D printing small splint external fixation and synchronous manual reduction combined with traditional small splint external fixation in the treatment of humeral shaft. METHODS: Between January 2021 and December 2022, 40 patients with humeral shaft fractures were treated with 3D printing small splints and traditional small splints. They were divided into 3D group and traditional group according to different fixation methods. Among them, there were 15 males and 5 females in the 3D group, aged from 20 to 52 years old with an average of (36.3±15.6) years old. In the traditional group there were 17 males and 3 females, aged from16 to 51 years old with an average of (32.9±17.2) years old. The occurrence of complications, duration of fracture healing, rate of fracture healing, subjective evaluation scores for brace comfort at 1 week and 4 weeks, as well as the Constant-Murley shoulder function score and Mayo elbow function score at 8 weeks and 16 weeks were compared between the two groups. RESULTS: All patients were followed up for 16 weeks. The 3D group did not experience any complications, while there were two cases of complications in the traditional group. However, this difference was not found to be statistically significant (χ²=2.105, P=0.146). The fracture healing time of the 3D group (90.1±4.5) days was significantly shorter compared to that of the traditional group (93.3±3.8) days (P<0.05). The subjective evaluation scores for brace comfort in the 3D group (53.7±2.3) points and (62.8±1.1) points were significantly higher than those in the traditional group (45.6±2.4) points and (52.3±1.4) points at 1 and 4 weeks after reduction (P<0.05). After 8 weeks of reduction, the Constant-Murley shoulder function score in the 3D group was(68.1±5.3) points, which demonstrated a statistically significant improvement compared to the traditional group(54.3±4.9) points (P<0.05). However, at 16 weeks post-reduction, there were no significant differences observed between the two groups (P>0.05). The Mayo elbow function score of the 3D group (84.1±7.5) points was significantly superior to that of the traditional group (79.5±6.8) points at 8 weeks post-reduction (P<0.05). However, there was no statistically significant difference between the two groups at 16 weeks post-reduction (P>0.05). CONCLUSION For humeral shaft fractures with conservative treatment indications, manual reduction combined with 3D printed small splints is a good choice for treatment. The patient's comfort level is higher, which can not only reduce the occurrence of complications, but also improve the fracture healing rate and joint function to a certain extent, and improve the patient's quality of life.
Humans ; Female ; Male ; Adult ; Middle Aged ; Humeral Fractures/physiopathology* ; Printing, Three-Dimensional ; Splints ; Adolescent ; Young Adult ; Fracture Healing

The relevant state departments issued a series of cost accounting systems,and put forward three disease cost accounting methods:project superposition method,service unit superposition method and parameter allocation method.Among them,parameter allocation method is not paid attention to in the theory and practice of hospital disease cost accounting.Based on the literature research,it clarifies the related concepts of disease cost accounting based on parameter allocation method,combs and summarizes the characteristics,accounting models and existing problems of disease cost accounting at home and abroad at present,and discusses the optimization and improvement path in order to promote the further improvement and popularization of this method and accelerate the extensive practical application of accounting results.

The relevant state departments issued a series of cost accounting systems,and put forward three disease cost accounting methods:project superposition method,service unit superposition method and parameter allocation method.Among them,parameter allocation method is not paid attention to in the theory and practice of hospital disease cost accounting.Based on the literature research,it clarifies the related concepts of disease cost accounting based on parameter allocation method,combs and summarizes the characteristics,accounting models and existing problems of disease cost accounting at home and abroad at present,and discusses the optimization and improvement path in order to promote the further improvement and popularization of this method and accelerate the extensive practical application of accounting results.

The relevant state departments issued a series of cost accounting systems,and put forward three disease cost accounting methods:project superposition method,service unit superposition method and parameter allocation method.Among them,parameter allocation method is not paid attention to in the theory and practice of hospital disease cost accounting.Based on the literature research,it clarifies the related concepts of disease cost accounting based on parameter allocation method,combs and summarizes the characteristics,accounting models and existing problems of disease cost accounting at home and abroad at present,and discusses the optimization and improvement path in order to promote the further improvement and popularization of this method and accelerate the extensive practical application of accounting results.

The relevant state departments issued a series of cost accounting systems,and put forward three disease cost accounting methods:project superposition method,service unit superposition method and parameter allocation method.Among them,parameter allocation method is not paid attention to in the theory and practice of hospital disease cost accounting.Based on the literature research,it clarifies the related concepts of disease cost accounting based on parameter allocation method,combs and summarizes the characteristics,accounting models and existing problems of disease cost accounting at home and abroad at present,and discusses the optimization and improvement path in order to promote the further improvement and popularization of this method and accelerate the extensive practical application of accounting results.

The relevant state departments issued a series of cost accounting systems,and put forward three disease cost accounting methods:project superposition method,service unit superposition method and parameter allocation method.Among them,parameter allocation method is not paid attention to in the theory and practice of hospital disease cost accounting.Based on the literature research,it clarifies the related concepts of disease cost accounting based on parameter allocation method,combs and summarizes the characteristics,accounting models and existing problems of disease cost accounting at home and abroad at present,and discusses the optimization and improvement path in order to promote the further improvement and popularization of this method and accelerate the extensive practical application of accounting results.

The relevant state departments issued a series of cost accounting systems,and put forward three disease cost accounting methods:project superposition method,service unit superposition method and parameter allocation method.Among them,parameter allocation method is not paid attention to in the theory and practice of hospital disease cost accounting.Based on the literature research,it clarifies the related concepts of disease cost accounting based on parameter allocation method,combs and summarizes the characteristics,accounting models and existing problems of disease cost accounting at home and abroad at present,and discusses the optimization and improvement path in order to promote the further improvement and popularization of this method and accelerate the extensive practical application of accounting results.

Warfarin is an irreplaceable oral anticoagulant for patients with mechanical heart valves, the stable pharmacogenetic-based warfarin dose prediction algorithms have improved the effectiveness and safety of warfarin anticoagulation therapy. Genetic factors are the main factors affecting the stable dose of warfarin. Single nucleotide polymorphisms such as VKORC1 and CYP2C9 affect the anticoagulation effect of warfarin through pharmacodynamic or pharmacokinetic pathways. Age, body surface area, combined use of drugs, and other nongenetic factors also affect the stable dose of warfarin. Previously published algorithms for warfarin dose prediction included mainly the white race, and most algorithms were constructed using traditional multiple linear regression. However, domestic studies have used machine learning methods to construct warfarin dose prediction algorithms based on the Chinese Han post-mechanical valve replacement population and have achieved better prediction efficiency. This article reviews the advances of warfarin anticoagulation influencing factors and the clinical application of stable dose prediction algorithms.

Warfarin is an irreplaceable oral anticoagulant for patients with mechanical heart valves, the stable pharmacogenetic-based warfarin dose prediction algorithms have improved the effectiveness and safety of warfarin anticoagulation therapy. Genetic factors are the main factors affecting the stable dose of warfarin. Single nucleotide polymorphisms such as VKORC1 and CYP2C9 affect the anticoagulation effect of warfarin through pharmacodynamic or pharmacokinetic pathways. Age, body surface area, combined use of drugs, and other nongenetic factors also affect the stable dose of warfarin. Previously published algorithms for warfarin dose prediction included mainly the white race, and most algorithms were constructed using traditional multiple linear regression. However, domestic studies have used machine learning methods to construct warfarin dose prediction algorithms based on the Chinese Han post-mechanical valve replacement population and have achieved better prediction efficiency. This article reviews the advances of warfarin anticoagulation influencing factors and the clinical application of stable dose prediction algorithms.