OBJECTIVE: To evaluate the effectiveness of double joystick technique assisted closed reduction and Kirschner wire internal fixation in the treatment of Gartland type Ⅲ supracondylar fractures of the humerus (SCFH) in children. METHODS: A retrospective study was conducted on 28 cases of Gartland type Ⅲ SCFH with complete data available, who underwent closed reduction and Kirschner wire internal fixation with the double joystick technique between August 2022 and July 2024. There were 23 boys and 5 girls, with an average age of 6.4 years (range, 1-12 years). All fractures resulted from falls and were classified as extension-type. X-ray film showed the radial displacement of the distal fragment in 15 cases and unlar displacement in 13 cases. The interval from injury to operation was 3-36 hours (mean, 19.5 hours). X-ray film re-examination was conducted to evaluate the fracture healing, and the Baumann angle of affected elbow joint and carrying angle of bilateral elbow joints were measured. Elbow joint function was evaluated using the range of motion (flexion and extension) and the Flynn criteria. The above indicators were compared between affected and healthy sides. RESULTS: All operation were successfully completed. The operation time ranged from 15 to 40 minutes (mean, 25.2 minutes). The length of hospital stay was 2-5 days (mean, 3.5 days). All patients were followed up 3-24 months (mean, 11.8 months). X-ray film confirmed fracture healing in all patients, with a mean healing time of 5.4 weeks (range, 4-6 weeks). At last follow-up, the Baumann angle of the affected elbow joint was (73.50±3.46)°, and the carrying angle and the range of motion in flexion and extension of the affected elbow joint were significantly less than the contralateral side (P<0.05). According to the Flynn criteria, the elbow joint function of the affected elbow was evaluated as excellent in 25 cases and good in 3 cases, with an excellent and good rate of 100%. CONCLUSION The double joystick technique is a safe and effective method which can facilitate the closed reduction and Kirschner wire internal fixation of Gartland type Ⅲ SCFH in children without increasing risk of complications.
Humans ; Male ; Female ; Humeral Fractures/diagnostic imaging* ; Fracture Fixation, Internal/instrumentation* ; Child ; Retrospective Studies ; Bone Wires ; Child, Preschool ; Fracture Healing ; Treatment Outcome ; Infant ; Elbow Joint/physiopathology* ; Range of Motion, Articular ; Closed Fracture Reduction/methods*

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Objective To investigate the clinical therapeutic effects of stretch regeneration according to law of tension stress for skin defects.Methods We reviewed the 16 patients with skin defect who had been treated at Department of Traumatic Orthopaedics and Hand Surgery,The First Affiliated Hospital,Guangxi Medical University by skin traction band made of a sterile blood transfusion apparatus and sterile nylon strips from March 2016 to July 2017.They were 12 males and 4 females,aged from 7 to 68 years (average,33 years).The areas of their skin defects ranged from 6 cm × 3 cm to 20 cm × 5 cm.After thorough debridement,a simple skin traction band made of a sterile blood transfusion apparatus and a number of aseptic nylon strips was placed on both margins of the wound,1 cm apart from the margin.The distances between wound holes ranged from 1.5 to 2.0 cm.The simple tension band was installed along the wound margins.After operation,the skin traction band was gradually tightened,according to the tension,blood supply to the skin margins and feeling of the distal end of the affected limb,to close the wound until interrupted suture of the skin was conducted.Results The wounds were closed by interrupted suture directly after application of the skin traction band in 13 of the 16 patients.The wounds were repaired by secondary vacuum sealing drainage (VSD) and skin graft in 2 cases with foot avulsed injury and infection in whom the traction band was pulled out along the wound skin margins.Skin graft was applied in one case with massive forearm skin defect and infection after the traction band failed.Follow-ups from 3 to 19 months revealed that application of the skin traction band led to linear scar healing,soft scar,little pigmentation,no tickle,no adjacent joint dysfunction due to skin contracture and normal pain sensation in most of the patients.Conclusion Stretch regeneration according to law of tension stress is an effective,simple and economical treatment of skin defects,deserving popularization.

Objective To investigate changes of coagulation function in patients with high altitude polycythemia (HAPC) .Meth‐ods Activated partial thromboplastin time (APTT) ,prothrombin time (PT) ,thrombin time (TT) and fibrinogen (Fbg) were de‐tected and compared between 69 patients with HAPC and 60 healthy subjects (controls) .Results Fbg ,APTT and TT levels in pa‐tients with HAPC were higher than controls (P<0 .05) ,while the difference of PT was not significant (P>0 .05) .Dynamic obser‐vation indicated that comprehensive therapy could these recover coagulation function .Conclusion Hemorrhage and coagulation process in patients with HAPC could be very complicated ,including physiological adaptation and the process of physiology evolving into pathology .

Objective To understand the current situation and level of clinical laboratory about the analysis of cellular morphology in Tibet region .Methods Authors investigated the information about the staff of clinical laboratory testing the patient′s blood smear under microscope ,executing the rules and regulations by using standard questionnaires .Results Some of the clinical laboratory didn′t founded the rule and standardization of rechecking about abnormal blood routine (5/15 ,33 .3% ) .Some of the divi-sion leadership didn′t pay enough attention to the staff′s basic operation (2/15 ,13 .3% ) .Most of the staff didn′t being trained about cellular morphology in special purpose workshop (6/43 ,88 .8% ) .Some of the hospital didn′t carried out the chemistry stai-ning about blood cells(10/15 ,66 .7% ) .Conclusion It′s important to promote the quality and level about the analysis of cellular morphology in Tibet region .

Objective To investigate the role of skin homing T lymphocytes in the development of psoriasis vulgaris(PV). Methods Indirect immunofluorescent double staining technique was employed to study the expression of infiltrating skin homing T lymphocytes in normal, uninvolved perilesional and lesional psoriatic skin in different stages (progressing, stable or regressing) and in normal human skin. Results ①Expression of cutaneous lymphocyte associated antigen (CLA) was found in the majority of CD3+T lymphocytes in normal human skin and in lesions of PV, and CD45RO phenotype was expressed in almost all CLA+T lymphocytes. ②In psoriatic lesions, the number of CD4+CLA+and CD8+CLA+cells was higher in progressive stage than that in stable stage(P