Tibiotalar or tibiocalcaneal arthrodesis using the ilizarov technique in the presence of infected nonunions of ankle joints / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the results of managing the infected nonunions of distal tibial fractures combined with talar fracture and calcaneal fracture with tibial bone transport, tibiotalar or tibiocalcaneal arthrodesis using the hybrid external fixator.</p><p><b>METHODS</b>A retrospective review of 26 patients who underwent either tibiotalar arthodesis or tibiocalcaneal arthodesis using an hybrid external fixator for infected nonunions of distal tibial fractures, talar and calcaneal fractures after tibial bone distraction was made. Each patient had a debridement of all infected and nonviable bones, the wound area were 2 cm×4 cm-4 cm×8 cm. The bony surfaces of distal tibia and talus were prepared for the fusion followed by application of an Orthofix's hybrid external fixator.</p><p><b>RESULTS</b>The remaining 18 patients undertook debridement at the docking sites, and 14 of them had autogenous bone grafting. There was a mean follow-up of 32 months (22-38 months). All the patients had successful fusions. There were no recurrent deep infections or amputations. Two patients had 6° of varus deformity at the docking site.</p><p><b>CONCLUSION</b>Tibiotalar or tibiocalcaneal arthrodesis using the Ilizarov technique is viable alternative to amputation in patients with infected nonunions,especially if there is a large bone loss of the tibias, talus and calcaneus.</p>

Update of treatment in pediatric influenza A (H1N1) infection / 国际儿科学杂志

Influenza A (H1N1) is an acute and zoonotic respiratory infectious illness, the prevention and treatment is very important in children as vulnerable groups.There are two mainly categories: neuraminidase inhibitors and M_2 inhibitors.The paper summarizes the characteristics of H1N1 and the latest progress in drug treatment and immunization prevention, as well as traditional medicine treatment,in order to improve public awareness of H1N1.

Analysis of Errors in Pharmaceutical Care and Prevention Measures / 中国药房

OBJECTIVE:To find out errors and to improve system of pharmaceutical care in order to promote the quality of pharmaceutical care.METHODS:Errors and their causes in the daily work were recorded and classified.Examples were illustrated to explain the cause of errors.RESULTS:Results of classification and case analysis showed that large apart of the errors were brought out by behavior of pharmaceutical care not in line with Check System,absence of vocational work,defective system and wicked compliance of patients.CONCLUSIONS:Series of measures and transformation of service conception will avoid the occurrence of errors effectively.

Autogenous and xenogenous osteochondral grafting and bone defect repair / 中国组织工程研究

Currently, materials to repair bone defects are various. Ideal material for bone transplantation should have properties of osteogenesis, bone induction, bone conductibility and biocompatibility. Autogenous or xenogenous osteochondral graft, cartilaginous membrane or periosteum graft and chondrocyte graft are commonly used grafts. Autogenous osteochondral graft exhibits advantages such as reliable graft and high survival rate of chondrocyte. However, due to donor area limitation, autogenous osteochondral grafting cannot meet requirements of repairing long-segmental bone defects. Thus, various materials are applied to repair articular cartilage defects. Cartilaginous membrane is frequently used, but its source and prolonged operation time limit its application. Xenogenous osteochondral material is relatively easily to obtain, and its size and appearance are not vigorously confined. Xenogenous osteochondral graft has bioactivity and can response to recipient. However, rejection reaction limits its application. Cryopreservation can retain osteogenetic activity and minimize immunogenicity but the bone biomechanical intensity is still significantly inferior to autogenous bone. To construct bioactive bone graft with enhanced chondrogenic capacity of bone graft by stimulation of various growth factors is the tendency of study on bone grafting materials.

Analysis of Pediatric Antibiotics in Our Hospital during the Period of 2002～2005 / 中国药房

OBJECTIVE:To evaluate status quo of the application of antibiotics for children and its trend.METHODS:The data about the amount and money of antibiotics used from2002to2005in out patient pharmacy of our hospital are collected and analyzed.RESULTS:Cephalothin,penicillin and azithromycin were widely used in our hospital and the using situation was reasonable at large,but some problems still existed.CONCLUSION:Rational using of antibiotics need efforts of all the departments in the hospital.

Treatment of equinus deformity with Ilizarov fixator / 中华创伤骨科杂志

Objective To evaluate the treatment of equinus deformity with Ilizarov fixator. Methods From February 2003 to August 2005, 17 patients with traumatic equinus were managed with Ilizarov fixator in our department. A preoperatively constructed ring fixator was applied on the involved foot and leg. Three days after the fixation, the compression threaded rod in the front and the distraction threaded rod at the back were respectively shortened and lengthened by turning the screw nuts on the rods 2 to 4 rounds in four times per day in the first week, and then 1 to 2 rounds in four times per day, which resulted in gradual correction of equinus deformity. The Fixation was maintained in neutral position for 2 to 3 months after achieving sufficient equinus correction to ensure the state of dorsiflexion. An ankle-foot orthosis was applied during resting and sleeping for more than three months after removal of the fixator. Results The mean follow-up period was 10 months (range, 7 to 14). All the patients achieved 0? dorsiflexion 4 to 6 weeks after the treatment while in the Ilizarov apparatus. The fixator was maintained in patients for an average of 14.5 weeks (10 to 16 weeks). No blood vessel or nerve was injured. Three patients had one mild pin track infection which responded to conventional management. A 20? equinus contracture reoccurred to one patient six weeks after the removal of the apparatus which had been maintained only for 10 weeks because the patient noted severe pain with the apparatus. One patient chose to accept his improved but persistent 10? equinus contracture. One patient who had had reconstructive surgery for his severely damaged leg muscles and tibial defect eventually required tibiotalar arthrodesis. Entire foot weight bearing with zero angle and walking without significant footdrop were achieved in the other 14 cases. Two patients complained of pain while bearing weight. Active ankle dorsiflexion of 10? beyond the neutral position was achieved in patients with functioning ankle dorsal extension muscles. Conclusion Ilizarov fixator is an effective technique to correct the equinus deformity because of its minimal invasion.