Objective:To discuss the clinical curative effect of the treatment of bundling bone fragment with figure-of-eight suture through double bone tunnels in the chronic bong mallet finger.Methods:A retrospective analysis was performed on patients with chronic bong mallet fingers who underwent surgery in the Department of Hand and Foot Microsurgery of Nanjing Jiangbei Hospital from May 2021 to February 2023. During the procedure, made into transverse double bone tunnels on the base of the distal phalanx with 0. 8 mm Kirschner wire, bundling bone fragment with figure-of-eight suture through double bone tunnels, then fixed with Kirschner wire elastic compression. Removal of the Kirschner wire 3 weeks after the procedure, the active flexion and extension range of the joints of the affected finger and the corresponding finger were measured at the last follow-up, then the range of motion (ROM) of the distal interphalangeal joint (DIPJ) and total action movement (TAM) of the fingers (affected and healthy finger) were recorded. The curative effects were evaluated according to the TAM system of the American Association of Hand Surgeons, including 4 grades: excellent, good, fair, and poor. SPSS 13. 0 software was used for statistical analysis of the data, and the measurement data conforming to normal distribution were expressed as Mean ± SD. The ROM of DIPJ and TAM of the affected finger were compared with the corresponding healthy finger 6 months after surgery by a paired sample t test. P<0. 05 indicates that the difference is statistically significant. Results:A total of 30 patients (30 digits) were enrolled, including 19 males and 11 females, and the age ranged from 18 to 62 years old, with an average age of 31 years old. The time from injury to operation was 24 to 65 days (mean of 35 days) . According to Wehbe and Schneider classification, there were 8 cases of type Ⅰa, 6 cases of type Ⅰb, 7 cases of type Ⅱa, 5 cases of type Ⅱb, 2 cases of type Ⅲa and 2 cases of type Ⅲb. All incisions healed well, the intraoperative blood loss was minimal, with no infection. All 30 cases were followed up for 6 to 7 months. All fractures were well aligned and healed, malformed fingers were completely corrected, and no needle tunnel infection or needle breakage were observed. At the last follow-up, the differences of the ROM of the DIPJ [ (30. 2±3. 5) °vs. (30. 4±3. 3) °, t=2. 57, P=0. 463] and the TAM [ (235. 3± 3. 6) ° vs. (237. 7± 4. 2) °, t=1. 78, P= 0. 247 ] between the affected and healthy fingers were not statistically significant. Finger function assessment: 27 cases were excellent, and 3 cases were good, and the excellent and good rate was 100%. Conclusion:Satisfactory therapeutic outcome for the treatment of chronic bong mallet finger deformity can be achieved by bundling bone fragment with figure-of-eight suture through double bone tunnels. It is an effective and practical method.

Objective:To discuss the clinical curative effect of the treatment of bundling bone fragment with figure-of-eight suture through double bone tunnels in the chronic bong mallet finger.Methods:A retrospective analysis was performed on patients with chronic bong mallet fingers who underwent surgery in the Department of Hand and Foot Microsurgery of Nanjing Jiangbei Hospital from May 2021 to February 2023. During the procedure, made into transverse double bone tunnels on the base of the distal phalanx with 0. 8 mm Kirschner wire, bundling bone fragment with figure-of-eight suture through double bone tunnels, then fixed with Kirschner wire elastic compression. Removal of the Kirschner wire 3 weeks after the procedure, the active flexion and extension range of the joints of the affected finger and the corresponding finger were measured at the last follow-up, then the range of motion (ROM) of the distal interphalangeal joint (DIPJ) and total action movement (TAM) of the fingers (affected and healthy finger) were recorded. The curative effects were evaluated according to the TAM system of the American Association of Hand Surgeons, including 4 grades: excellent, good, fair, and poor. SPSS 13. 0 software was used for statistical analysis of the data, and the measurement data conforming to normal distribution were expressed as Mean ± SD. The ROM of DIPJ and TAM of the affected finger were compared with the corresponding healthy finger 6 months after surgery by a paired sample t test. P<0. 05 indicates that the difference is statistically significant. Results:A total of 30 patients (30 digits) were enrolled, including 19 males and 11 females, and the age ranged from 18 to 62 years old, with an average age of 31 years old. The time from injury to operation was 24 to 65 days (mean of 35 days) . According to Wehbe and Schneider classification, there were 8 cases of type Ⅰa, 6 cases of type Ⅰb, 7 cases of type Ⅱa, 5 cases of type Ⅱb, 2 cases of type Ⅲa and 2 cases of type Ⅲb. All incisions healed well, the intraoperative blood loss was minimal, with no infection. All 30 cases were followed up for 6 to 7 months. All fractures were well aligned and healed, malformed fingers were completely corrected, and no needle tunnel infection or needle breakage were observed. At the last follow-up, the differences of the ROM of the DIPJ [ (30. 2±3. 5) °vs. (30. 4±3. 3) °, t=2. 57, P=0. 463] and the TAM [ (235. 3± 3. 6) ° vs. (237. 7± 4. 2) °, t=1. 78, P= 0. 247 ] between the affected and healthy fingers were not statistically significant. Finger function assessment: 27 cases were excellent, and 3 cases were good, and the excellent and good rate was 100%. Conclusion:Satisfactory therapeutic outcome for the treatment of chronic bong mallet finger deformity can be achieved by bundling bone fragment with figure-of-eight suture through double bone tunnels. It is an effective and practical method.

This paper investigates the tangible and effective coverage of grass-roots Party organizations in tertiary public hospitals in Shanghai,sorts out the coverage and coverage methods,explores the problems encountered and puts forward counter-measures,so as to give full play to the role of grass-roots Party organizations as the battle fortress,strengthen the Party building in public hospitals,and further promote the reform of the medical and health system and the construction of healthy China.

Acute pancreatitis is a common acute abdomen with a variety of causes and natural course.The incidence rate is increasing year by year.Some patients may develop severe acute pancreatitis,with serious complications and a high risk of death.Therefore,early prediction of the severity of the patient's condition and active treatment are beneficial to reduce the severity and mortality rate of patients and improve the prognosis of patients.In order to predict the severity of acute pancreatitis,many prediction methods have emerged in the clinic,including acute C-reactive protein,urea nitrogen,thyroid hormone,hematocrit,inflammatory factors,visceral fat area,pancreatic necrosis volume,APACHEⅡ,Ranson score,BISAP,EPIC,MCTSI,etc.This article summarizes the serological indicators,imaging methods and scoring systems that can be used to predict severe acute pancreatitis,focusing on their characteristics and limitations.

Acute pancreatitis is a common acute abdomen with a variety of causes and natural course.The incidence rate is increasing year by year.Some patients may develop severe acute pancreatitis,with serious complications and a high risk of death.Therefore,early prediction of the severity of the patient's condition and active treatment are beneficial to reduce the severity and mortality rate of patients and improve the prognosis of patients.In order to predict the severity of acute pancreatitis,many prediction methods have emerged in the clinic,including acute C-reactive protein,urea nitrogen,thyroid hormone,hematocrit,inflammatory factors,visceral fat area,pancreatic necrosis volume,APACHEⅡ,Ranson score,BISAP,EPIC,MCTSI,etc.This article summarizes the serological indicators,imaging methods and scoring systems that can be used to predict severe acute pancreatitis,focusing on their characteristics and limitations.

Objective:To evaluate the clinical efficacy of the treatment of boutonniere deformity by tenodesis of the bilateral slips of the flexor digitorum superficialis (FDS) tendon.Methods:From February 2021 to May 2022, the boutonniere deformity was retrospectively analyzed, by tenodesis of the bilateral slips of the FDS in the Department of Hand and Foot Microsurgery of Nanjing Jiangbei Hospital.During the operation, the lateral side of the bilateral FDS was split at the distal end separately. Then the two bundles were tunneled through the bone of the middle phalanx and weaved with the central band of the extensor tendon. The involved finger was stabilized in extension with splinting for 4 weeks after surgery. Extension and flexion of the proximal interphalangeal joint(PIPJ) of the finger should be gradually strengthened. Finger function was evaluated according to the total action movement (TAM) system of the American Association of Hand Surgeons.Results:A total of 7 patients (7 digits) were enrolled, including 5 males and 2 females, and the age ranged from 22 to 64 years old, with an average age of 42 years old. The injured included 1 index finger, 2 middle fingers, 2 ring fingers, and 2 little fingers. These patients were follow-up for 6 to 8 months with an average of 7 months. All wounds healed by primary intention. This operation can obtain the complete correction of the boutonniere deformity. The PIPJ was stable and capable of active flexion and straightness. The straightness of PIPJ and distal interphalangeal joint was improved. The mean active motion of the PIPJ of the affected finger was 92.4°, and the mean TAM of the affected finger was 271.3°. According to TAM system assessment criteria: excellent in 6 patients, good in 1 patient.Conclusion:It is a safe and effective new method for the correction of boutonniere deformity, which can be effectively treated with tenodesis of the bilateral slips of the FDS.

Objective:To evaluate the clinical efficacy of the treatment of boutonniere deformity by tenodesis of the bilateral slips of the flexor digitorum superficialis (FDS) tendon.Methods:From February 2021 to May 2022, the boutonniere deformity was retrospectively analyzed, by tenodesis of the bilateral slips of the FDS in the Department of Hand and Foot Microsurgery of Nanjing Jiangbei Hospital.During the operation, the lateral side of the bilateral FDS was split at the distal end separately. Then the two bundles were tunneled through the bone of the middle phalanx and weaved with the central band of the extensor tendon. The involved finger was stabilized in extension with splinting for 4 weeks after surgery. Extension and flexion of the proximal interphalangeal joint(PIPJ) of the finger should be gradually strengthened. Finger function was evaluated according to the total action movement (TAM) system of the American Association of Hand Surgeons.Results:A total of 7 patients (7 digits) were enrolled, including 5 males and 2 females, and the age ranged from 22 to 64 years old, with an average age of 42 years old. The injured included 1 index finger, 2 middle fingers, 2 ring fingers, and 2 little fingers. These patients were follow-up for 6 to 8 months with an average of 7 months. All wounds healed by primary intention. This operation can obtain the complete correction of the boutonniere deformity. The PIPJ was stable and capable of active flexion and straightness. The straightness of PIPJ and distal interphalangeal joint was improved. The mean active motion of the PIPJ of the affected finger was 92.4°, and the mean TAM of the affected finger was 271.3°. According to TAM system assessment criteria: excellent in 6 patients, good in 1 patient.Conclusion:It is a safe and effective new method for the correction of boutonniere deformity, which can be effectively treated with tenodesis of the bilateral slips of the FDS.

OBJECTIVE To evaluate the effectiveness， safety and economy of baloxavir marboxil in the treatment of influenza， and to provide evidence-based reference for the introduction of new drugs in hospitals and clinical medication decisions. METHODS Retrieved from PubMed， Embase， Web of Science， Cochrane Library， Epistemonikos， CBM， CNKI， VIP， Wanfang database， official websites and relevant databases of health technology assessment （HTA） institutions， the results of the included studies were descriptively analyzed after literature screening， data extraction and quality evaluation. RESULTS A total of 11 studies were included， involving 6 systematic reviews/meta-analyses and 5 pharmacoeconomic studies. Compared with placebo， baloxavir marboxil significantly shortened the time to alleviation of symptoms （TTAS） and time to resolution of fever （TTRF）， reduced the virus titer change from baseline at 24 h and 48 h after treatment and the incidence of bronchitis， with statistical significance （P＜ 0.05）. Compared with neuraminidase inhibitors （NAIs）， there were no significant differences in shortening TTRF and reducing the incidence of complications， pneumonia and bronchitis （P＞0.05）. The majority of studies suggested that there were no significant differences in shortening TTAS （P＞0.05）. Only very low-quality literature suggested that baloxavir marboxil could significantly reduce the virus titer change from baseline at 24 h and 48 h after treatment. In terms of safety， the incidences of adverse events （AEs） and drug-related adverse events （DRAEs） induced by baloxavir marboxil showed no significant differences， compared with peramivir and zanamivir （P＞0.05）. Some studies considered that the incidences of AEs and DRAEs with baloxavir marboxil were lower than placebo， oseltamivir and laninamivir. Compared with oseltamivir in China and laninamivir in Japan， baloxavir marboxil showed cost-effectiveness advantages. CONCLUSIONS Compared with placebo， baloxavir marboxil has good efficacy， safety and economy. Compared with NAIs （oseltamivir）， baloxavir marboxil has good economic advantages in China， but further high-quality studies are still needed regarding its safety and efficacy.

Objective:To explore the effect of the treatment of tendinous mallet finger deformity by the minimally invasive percutaneous quantitative suture technique eight times.Methods:A retrospective analysis was performed on patients with fresh tendinous mallet fingers who underwent surgery in the Department of Hand and Foot Microsurgery of Nanjing Jiangbei Hospital from April 2021 to April 2022. During the procedure, the extensor digitalis tendon in the zone Ⅰ was sutured percutaneous with 3-0 thread monofilament sutures in the "quantitative 8-stitch method" according to the pre-marked number sequence of 1 to 8, and fixed at the base of the distal phalanx via a constructed bone tunnel. Removal of the Kirschner wire 8 weeks, the brace was used to fix the affected finger in the dorsal extension. The flexion and extension of the affected finger were gradually strengthened. The function of the affected finger was evaluated according to the Crawford standard after operation and follow-up: the active flexion and extension range of motion of each joint of the affected finger and the contralateral healthy finger was measured, and the total active ranges of motion of the finger were recorded. Finger function was evaluated according to the total active range of motion (TAM) system of the American Association of Hand Surgeons.Results:A total of 10 patients (10 digits) were enrolled, including 7 males and 3 females, and the age ranged from 20 to 52 years old, with an average age of 36.5 years old. The distance of tendon break was ≤10 mm. The operation time of the patients was 20-30 min, with an average of 24.5 min. The intraoperative blood loss was minimal. All 10 cases were followed up and the follow-up period was 6 to 12 months, with an average of 7 months. Mallet finger deformities were all corrected postoperatively, dorsal skin of fingers without a scar, there were no knot exposure, skin necrosis and other complications. At the last follow-up, the mean active range of motion of the distal interphalangeal joint was 84.4° and the mean TAM of the injured finger was 265.6°. According to TAM system assessment criteria: 8 cases were excellent, and 2 cases were good.Conclusions:Satisfactory therapeutic outcome for the treatment of tendinous mallet finger deformity can be achieved by the minimally invasive percutaneous quantitative suture technique eight times. It is a simple, safe, and effective method with minimal invasion.

Objective:To explore the effect of the treatment of tendinous mallet finger deformity by the minimally invasive percutaneous quantitative suture technique eight times.Methods:A retrospective analysis was performed on patients with fresh tendinous mallet fingers who underwent surgery in the Department of Hand and Foot Microsurgery of Nanjing Jiangbei Hospital from April 2021 to April 2022. During the procedure, the extensor digitalis tendon in the zone Ⅰ was sutured percutaneous with 3-0 thread monofilament sutures in the "quantitative 8-stitch method" according to the pre-marked number sequence of 1 to 8, and fixed at the base of the distal phalanx via a constructed bone tunnel. Removal of the Kirschner wire 8 weeks, the brace was used to fix the affected finger in the dorsal extension. The flexion and extension of the affected finger were gradually strengthened. The function of the affected finger was evaluated according to the Crawford standard after operation and follow-up: the active flexion and extension range of motion of each joint of the affected finger and the contralateral healthy finger was measured, and the total active ranges of motion of the finger were recorded. Finger function was evaluated according to the total active range of motion (TAM) system of the American Association of Hand Surgeons.Results:A total of 10 patients (10 digits) were enrolled, including 7 males and 3 females, and the age ranged from 20 to 52 years old, with an average age of 36.5 years old. The distance of tendon break was ≤10 mm. The operation time of the patients was 20-30 min, with an average of 24.5 min. The intraoperative blood loss was minimal. All 10 cases were followed up and the follow-up period was 6 to 12 months, with an average of 7 months. Mallet finger deformities were all corrected postoperatively, dorsal skin of fingers without a scar, there were no knot exposure, skin necrosis and other complications. At the last follow-up, the mean active range of motion of the distal interphalangeal joint was 84.4° and the mean TAM of the injured finger was 265.6°. According to TAM system assessment criteria: 8 cases were excellent, and 2 cases were good.Conclusions:Satisfactory therapeutic outcome for the treatment of tendinous mallet finger deformity can be achieved by the minimally invasive percutaneous quantitative suture technique eight times. It is a simple, safe, and effective method with minimal invasion.