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During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.
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Objective:To observe the effect of combining scalp acupuncture with feedback training on muscle tone, motor ability, plantar pressure distribution and joint range of motion of stroke survivors with lower limb spastic paralysis.Methods:A total of 212 stroke survivors were randomly divided into a combination group ( n=70), an exercise group ( n=70) and a scalp acupuncture group ( n=72) according to a random number table. All of the patients received routine medication and 120 minutes of rehabilitation training six days a week for 8 consecutive weeks. The rehabilitation training included guidance on good posture, posture change training, balance training and gait training. The scalp acupuncture and exercise groups were additionally provided with 40 minutes of scalp acupuncture and lower limb intelligent feedback training, while the combination group was given both. Muscle tension, balance and lower extremity movement were quantified before and after the training, and a gait evaluation system was used to detect the plantar pressure distribution on the affected side and the range of motion range of the lower limb joints during walking. Results:After the treatment, significant differences were observed in the average modified Ashworth scores, modified Berg scale scores, Fugl-Meyer lower extremity ratings and modified Barthel Index scores compared with before the treatment. The average scores of the combination group were then significantly better than those of the other two groups. The average load bearing ratios of the affected toes, metatarsal bones Ⅰ-V, medial arch, external arch, medial heel and external heel had improved significantly in all of the groups, with the improvement of the combination group again significantly greater than those of the other groups. The same pattern of improvement was observed in the groups′ average pelvic rotation angles, hip flexion angles, knee flexion angles and ankle dorsiflexion angles.Conclusion:Combining scalp acupuncture with intelligent feedback can significantly improve lower extremity functioning after a stroke. That should improve performance in the activities of daily living of stroke survivors.
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Modern trauma scoring system tries hard to reflect and evaluate various injury severity and outcome in an objective，accurate and quick manner via digitalization so as to make correct diagnosis and treatment plan. However，current trauma scoring is mainly responsible for predicting death outcome，and it cannot reflect the changes of trauma rehabilitation function outcome in a dynamic way，thus making it difficult to meet clinical demands. In recent years，artificial intelligence technology and big data mining technology are helpful to integrate and analyze a large number of clinical data generated in the process of trauma treatment，and have a great application value for the continuous assessment of the whole trauma process. Such being the case，the authors sum up the research progress of physiology scoring，anatomy scoring，composite scoring of physiology and anatomy，functional scoring and artificial intelligence in trauma evaluation，attempting to provide references for building a new trauma scoring system.
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Objective@#To explore the clinical effect of mometasone furoate nasal spray combined with montelukast in the treatment of children with obstructive sleep apnea hypopnea syndrome (OSAHS), and to analyze its feasibility and clinical application value.@*Methods@#From August 2017 to March 2019, 64 children with OSAHS who were treated in the People's Hospital of Jinhua were selected in the study.According to the random number table method, they were divided into the observation group and the control group, with 32 cases in each group.The observation group was treated with mometasone furoate nasal spray combined with montelukast for 12 weeks.The control group was treated with surgical treatment to remove hypertrophic tonsils and/or adenoids.The clinical symptom scores, polysomnography(PSG) monitoring index, adenoid and tonsil size index, and the efficacy after 12 weeks of treatment were compared between the two groups.@*Results@#There were no statistically significant differences in symptom scores and minimum arterial oxygen saturation(LSaO2) between the two groups before treatment(all P>0.05). After treatment, the symptom scores and LSaO2 of the control group were (1.90±0.53)points and (94.74±1.54)%, respectively, which of the observation group were (4.00±1.50)points and (85.34±10.57)%, respectively, the differences between the two groups were statistically significant(t=-7.416, 4.972, all P<0.05). There were statistically significant differences in the apnea hypopnea index(AHI) and obstructive apnea index(OAI) between the two groups(all P<0.05). After treatment, the A/N of the adenoids in the observation group was significantly decreased, and the difference in the tonsil classification was statistically significant(Z=-2.602, P<0.05). The effective rate of the observation group was 56.25%(18/32), which was significantly lower than that of the control group [100.00%(32/32)], the difference was statistically significant(χ2=17.920, P<0.05).@*Conclusion@#In summary, non-surgical treatment can alleviate OSAHS-related symptoms, reduce the size of tonsils and adenoids, and achieve the purpose of remission or cure.Non-surgical treatment can be selected when patients' families are reluctant to choose surgical treatment.
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Objective To investigate the clinical efficacy of arthroscopic Brostr(o)m-Gould procedure for chronic lateral ankle instability (CLAI).Methods A retrospective case series study was conducted to analyze the clinical data of 36 CLAI patients admitted to Zhejiang Provincial People's Hospital,Second Affiliated Hospital of Shenzhen University,Institute of Orthopedics of Soochow University,and Guangzhou Orthopedic Hospital from August 2016 to July 2017.There were 21 males (21 ankles) and 15 females (15 ankles),aged 18-42 years [(26.5 ± 8.6)years].The duration from injury to operation ranged from 6 to 30 months [(10.8-± 1.6) months].All patients received arthroscopic Brostr(o)m-Gould procedure (anterior talofibular ligament repair,capsular constriction,subextensor ligament reinforcement).The operation time and arthroscopic intra-articular lesions and treatment were recorded,and the wound healing and complications were recorded.The visual analogue score (VAS),front drawer test and varus stress test results,American Orthopedic Foot and Ankle Surgery Society (AOFAS) ankle-hind foot score and Karlsson-Peterson ankle function score were compared before operation,6 weeks after operation and at the last follow-up.Results All 36 patients were followed up for 18-29 months [(20.5 ±6.3) months].The operation time ranged from 45 to 115 minutes [(67.2 ± 18.6) minutes].During the operation,synovitis hyperplasia of ankle joint was found in 35 patients,scar tissue around ligament in 32,talus cartilage injury in 10,osteophyte in 19 and free body in 5,all of which were treated accordingly.All incisions were healed in the first stage after operation,without joint infection,superficial sural nerve injury or thread stimulation.The ankle varus was slightly limited in two patients after operation and improved after functional rehabilitation.No revision operation was needed at the last follow-up.Front drawer test and inverted stress test results were negative (-).The VAS score was (5.9 ± 1.6) points before operation,(1.9 ± 1.0) points at 6 weeks after operation,and (1.6 ± 0.3) points at the last follow-up,with significant difference compared with that before operation (P ＜ 0.01).The AOFAS ankle-hind foot score was (67.4 ± 7.4) points before operation,(89.2 ±4 6.8) points at 6 weeks after operation,and (91.7 ±5.3)points at the last follow-up,with significant difference compared with that before operation (P ＜ 0.01).Karlsson-Peterson ankle function score was (65.3 ± 9.6)points before operation,(88.6 ± 5.3) points at 6 weeks after operation,and (90.6 ± 3.8) points at the last follow-up,with significant difference compared with that before operation (P ＜ 0.0 1).Conclusion For CLAI,the arthroscopic Brostr(o)m-Gould procedure can treat the intra-articular lesions and reliably restore the stability of the lateral ankle.At the same time,quick motion recovery can be achieved,with satisfactory shortterm curative effect.
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Objective To investigate the range of gray values of MRI local hyperintensity signals corresponding to the classification of partial tear of knee anterior cruciate ligament (ACL) under arthroscopy so as to evaluate its significance for diagnosis and treatment of acute partial ACL tear.Methods A retrospective analysis was conducted of 82 patients who had identical orthopaedic and MRI findings at Department of Orthopaedics and Traumatology,Shenzhen Baoan People's Hospital from January 2014 to June 2016.They were 49 males and 33 females;their ages ranged from 18 to 71 years,with an average of 39.6 years;27 left and 55 right knees were involved.Of them,67 were assigned into an ACL tear group in which both arthroscopic and MRI findings indicated diagnosis of acute ACL partial tear,and 15 into an ACL normal group in which both arthroscopic and MRI findings indicated diagnosis of normal ACL but injury to meniscus and/or articular cartilage.According to the arthroscopic grading,the 67 patients were rated as grade Ⅰ in 21 cases,as grade Ⅱ in 19,and as grade Ⅲ in 27.Software Photoshop CS4.0 was used to measure the gray values of local hyperintensity signals of the partial ACL tear in the MRI in the ACL tear group and the overall gray values of local hyperintensity signals of the normal ACL in MRI in the ACL normal group.The 2 groups were compared in terms of the range of gray values of MRI local hyperintensity signals and the proportion of ACL partial tear under arthroscopy.Results The range of gray values of MRI local hyperintensity signals in diagnosis of acute ACL partial tear was 20.24 ± 7.77 for the ACL normal group,67.54 ± 8.78 for the grade Ⅰ ACL partial tear,90.99 ± 7.21 for the grade Ⅱ tear,and 138.89 ± 32.40 for the grade Ⅲ tear,showing significant differences between the 4 groups and any 2 of the 4 groups as well (both P ＜ 0.05).The percentage of ACL partial tear under arthroscopy was 0 for the ACL normal group,0.22 ± 0.08 for the grade Ⅰ ACL partial tear,0.56 ± 0.08 for the grade Ⅱ tear,and 0.84 ± 0.064 for the grade Ⅲ tear,showing significant differences between the 4 groups and any 2 of the 4 groups as well (both P ＜ 0.05).Twenty-six patients (21 cases of grade Ⅰ and 5 ones of grade Ⅱ tear) received symptomatic treatment of the injury to the meniscus and/or articular cartilage without ACL reconstruction due to good function of residual ACL and stable knee joint.Forty-one patients (14 cases of grade Ⅱ and 27 ones of grade Ⅲ tear) underwent ACL reconstruction and treatment of co-morbidities because of poor function of residual ACL and instability of the knee joint.Conclusion The range of gray values of MRI local hyperintensity signals can be used to assist diagnosis and classification of acute ACL partial tear.
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Objective To explore the effect of practicing Chinese gymnastic Qigong-Yijinjing on the infrared radiant track along meridian course (IRRTM)of Ren Meridian stimulated by moxibustion on CV-8 among dysmenorrhea patients.Methods Twenty dysmenorrhea undergraduate patients were recruied and practiced Chinese gymnastic Qigong-Yijinjing for 3 months.The numbers of patients of mild,moderate and severe symptoms were collected before and after the intervention.The effects of IRRTM stimulated by moxibustion on CV-8 were compared before and after practicing Chinese Gymnastic Qigong-Yijinjing.Results After practicing Chinese Gymnastic Qigong-Yijinjing,symptoms of 15 patients (including 11 with moderate dysmenorrhea and 4 with severe dysmenorrheal)were relieved to different extent.After the practice,all IRRTM of Ren Meridian turn to be more continuous,clear and regular either the Ren Meridian was stimulated with moxibustion or not.The average surface temperature along Ren Meridian rose significantly after the practicing.The conduction time to achieve the best states of IRRTM along Ren Meridian significantly shortened compared to before the intervention.Conclusion Chinese Gymnastic Qigong-Yijinjing can effectively enhance the transmission of IRRTM along Ren Meridian on dysmenorrhea patients,and may have a positive effect on dysmenorrhea treatment.
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Recently,wide application of MRI in clinic accelerates researches into the etiology,diagnosis,treatment and prognosis of bone bruises.MRI manifestations of bone bruises include trabecular microfracture associated with hemorrhage,oedema of subchondral bone because of direct or indirect traumatic force and focal abnormalities in subchondral bone of the knee.This condition is also known as occult injury of the knee,because it is likely to be overlooked or misdiagnosed in hospital due to its diagnostic difficulty by plain radiographs and CT.If timely intervention is not given,it will be accompanied by chronic pain which seriously affects the daily life of the patients,even resulting in early degeneration.This article discusses the current research on bone bruises of the knee.
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Atrial fibrillation is an important cause of ischemic stroke.Studies have shown that the acute ischemic stroke patients with atrial fibrillation may have more severe neurological deficits and higher mortality compared with those without atrial fibrillation.In addition,atrial fibrillation is also an independent risk factor for the failure of recanalization after iotravenous thrombolysis,and it is associated with poor outcome.Mechanical thrombectomy treatment provides a new therapeutic regimen for acute ischemic stroke patients with atrial fibrillation.This article reviews the intravenous thrombolysis and mechanical thrombectomy for acute ischemic patients with atrial fibrillation.
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BACKGROUND:Osteoarthritis is an age-related joint disease characterized by articular cartilage degeneration. OBJECTIVE:To assess the expression of miR-140-3p in synovial fluid of knee osteoarthritis, and identify whether miR-140-3p levels in synovial fluid are correlated with disease severity. METHODS:We col ected 10 healthy volunteers, 10 patients with gouty arthritis, 10 patients with rheumatoid arthritis, and 45 patients with knee osteoarthritis (15 cases in early stage, 15 cases in middle stage and 15 cases in the late stage). Real-time fluorescence quantitative PCR was used to detect miR-140-3p expression in synovial fluid in each group. RESULTS AND CONCLUSION:(1) Expression of miR-140-3p was significantly down-regulated in knee osteoarthritis group. Significant differences in miR-140-3p expression were detected between non-knee osteoarthritis group and knee osteoarthritis group (P0.05). (2) The miR-140-3p expression in the healthy control group was 11.4 times that in the knee osteoarthritis group. The expression of miR-140-3p decreased with the increase of the severity of osteoarthritis. (3) Spearman rank correlation analysis suggested that the expression of miR-140-3p was negatively correlated with osteoarthritis severity. (4) Results suggest that the expression of miR-140-3p in synovial fluid can reflect the progression of knee osteoarthritis to a certain extent.
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Objective To investigate the effect of electroacupuncture at point Zusanli (ST36) on gastric expression of heat shock protein 70 (HSP70) mRNA in rats with stress gastric ulcer and explore the molecular mechanism of its prevention and treatment of gastric ulcer. Method Fifty-one SD rats were randomly allocated to normal control (normal), stress gastric ulcer (model) and electroacupuncture at point Zusanli (electroacupuncture) groups. A model of stress gastric ulcer was made by cold restraint. From the second day after model making, the electroacupuncture group received electroacupuncture at point Zusanli 20 min once daily for three consecutive days, with left and right points Zusanli alternately needled; the model group, the same restraint treatment as in the electroacupuncture group; the normal group, no treatment. Gastric mucosal ulcer index (UI) was calculated using the GUTH’s method. The pathological morphology of gastric tissue was observed by HE staining. Gastric HSP70 mRNA expression was determined by RT-PCR. Result Different numbers and sizes of obvious gastric mucosal ulcers were observed, UI increased significantly (P<0.001) and HSP70 mRNA expression decreased significantly (P<0.05) in the model group compared with the normal group. The pathological change in gastric tissue improved somewhat, gastric mucosal UI decreased significantly (P<0.05) and HSP70 mRNA expression increased significantly (P<0.01) in the electroacupuncture group compared with the model group. Conclusion Electroacupuncture at point Zusanli can upregulate gastric HSP70 mRNA expression and promote the repair of gastric mucosa injuries in rats with stress gastric ulcer.
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To improve higher training quality and capacity of orthopedic postgraduates,early contact education,problem-base learning combined with co-supervisor with radiologists were engaged for orthopedic postgraduates since 2008.Effect of the practice was assessed by postgraduates one year later.Investigation revealed that practice aroused learning enthusiasm and initiative,promoted comprehensive understanding of orthopedic knowledge,set up social responsibility,and constructed innovative thinking.
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ObjectiveTo explore the diagnostic and predictive value of troponin Ⅰ,lactic acid and hypersensitive C-reactive protein(hs-CRP) in viral myocarditis.MethodsTroponin Ⅰ,hs-CRP,lactic acid blood levels in different time were measured in 88 patients with acute viral myocarditis(54 cases) or acute upper respiratory infections (34 cases).Troponin Ⅰ leyel in patients with severe 39 cases and mild VMC 15 cases were compared.ResultsTroponin Ⅰ level of VMC group was (0.59 ±0.10) ng/L,and significantly higher than that of acute upper respiratory infection group [ (0.10 ± 0.08 ) ng/L ] ( t =2.79,P ＜ 0.05 ).And higher lactic acid and hs-CRP level were observed at different period ( t =2.71,2.48,all P ＜ 0.05).ConclusionTroponin I could help diagnose VMC predict the severity of myocarditis to some extent.Lactic acid and hs-CRP could also reflect imflammation injury of VMC.
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ObjectiveTo discuss the clinical efficacy of low dose heparins and low molecular weight heparins (LMWHs) in the treatment of severe traumatic disseminated intravascular coagulation (DIC).MethodsA total of 77 trauma patients (APACHE Ⅱ score for 5-10) with secondary DIC in ICU were included and randomly assigned to three groups,ie,Group A (26 patients,subcutaneously injected with LMWHs at doses of 75-150 U · kg-1 · d-1,with the average incipient dose of 4 000 U/d),Group B (25 patients,subcutaneously injected with heparins at doses of 100-250 U · kg-1 · d-1,with the average incipient dose of 5000 U/d and control group (26 patients,supplemented with simple blood coagulation factor).The injection volume was adjusted according to the level of antithrombin Ⅲ ( ATⅢ ) in each group.Within 28 days in ICU,the three groups were compared in aspects of deaths,hospital day,bleeding rate,thrombin time (TT),prothrombin time (PT),activation part thrombin time ( APTT),fibrinogen (Fg),antithrombin Ⅲ ( AT Ⅲ ) and D-dimer.Results ( 1 ) The differences of mortality were both insignificant in the control group comparel with Group A and Group B respectively at day 28 ( P ＜ 0.05 ).(2) The ICU stay of three groups showed significant differences ( P ＜ 0.01 ),with longer stay of Groups A and B than control group ( P ＜ 0.01 ) and longer stay of Group A than Group B ( P ＜ 0.05 ).( 3 ) Except for AT Ⅲ ( P ＜ 0.01 ),other blood coagulation indices showed no significant difference among three groups.(4) The differences of bleeding rate were not significant between Group A and control group (P ＞ 0.05),but significant between Group B and control group (p ＜ 0.05 ).(5) Related factor analysis indicated significant relationship between AT Ⅲ level and bleeding rate (P ＜0.01 ).ConclusionsLow dose heparins and LMWHs are beneficial to controlling traumatic DIC,but the heparin therapy adjusted by the level of AT Ⅲ with marked correlation bleeding rate shows lower bleeding rate as compared with LMWHs.
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The levels of low-density lipoprotein(LDL)glycation from control group,diabetic HbA1C 7.0% groups were(17.7±2.31),(34.29±5.73),and(48.79±7.82)Glycogroups/LDL by fluorimetry.The LDL binding to its receptor in three groups were(37.65±5.20),(27.36±4.34),and(15.07± 2.23)ng/mg cell protein measured by enzyme-linked immunoreceptor assay.The glycated levels in two diabetic groups were higher than that in control group,and higher in HbA1C>7.0% group than in HbA1C<7.0% group(all P< 0.01).The results of LDL binding capacity to its receptor were just the opposite.
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Objective To investigate the effects of azithromycin on airway remodeling and the expression of transforming growth factorβ1 (TGF-β1) in asthmatic mice.Methods BALB/c male mice were random divided into 3 groups:control group(A),asthma group (B),and azithromycin treated group (C),with 10 mice in each group.Bronchoalveolar lavage fluid was collected to count the number of white blood cells and eosinophilic granulocytes EOS.The morphological parameters of the bronchi were measured by computer image analysis and the pathologic changes of the bronchi and lung tissue were observed by HE staining.The expressions of TGF-β1 were detected by immunohistochemistry.Results The number of EOS in B group was significantly higher than that in control group(8.12 ±0.54 vs 0.70 ±0.40;8.12 ±0.54 vs 0.87 ±0.25,P ＜0.01).WAt and WAi and WAm in group C was significantly lower than that in group B (10.15 ±0.95 vs 15.36 ±0.85,4.16 ±0.32 vs 10.64 ± 1.03,3.77 ±0.15 vs 7.97 ±0.17,P ＜0.01)but higher than that in group A.The expression of TGF-β1 in group C was significantly lower than that in group B but higher than that in group A.TGF-β1 expression of lung tissue in C group was significantly correlated with EOS,(r =0.840,P ＜0.01) and WAt(r =0.735,P ＜0.01) and WAm (r =0.870,P ＜0.01).Conclusion Azithromycin inhibited airway remodeling in asthmatic mice,which might possibly be achieved through inhibiting the expression of TGF-β1.
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Prospective studies have indicated that the incidence of recurrent stroke in patients with symptomatic intracranial arterial stenosis is approximately 15-20％ per year,and the mortality rate is significantly higher.Although the strict control of the risk factors for atherosclerosis and antithrombotic drugs,especially the use of anti-platelet drugs,is the main basis treatment for these patients,some patients may have drug resistance.These high-riskpatients showed severe stenosis ( ＞ 70％ ) of the recent clinical symptoms of ischemia and theclinical and imaging evidence of distal hemodynamic irnpairment accompanying arterial stenosis.The advances in balloon and stenting have made people begun to consider the possibility ofusing angioplasty and stenting for the treatment of these high-risk patients.However,becausethe relative efficacy of these invasive therapy and drug therapy is not very clear,furtherrandomized clinical trial is still needed.This article reviews the available drug treatment optionsfor symptomatic intracranial arteriosclerotic disease and the current status of endovascudartreatment.
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Objective To standardize the procedure and ensure the safety of oral administration,and to achieve the "three-accurate",that is right medicine,right time,and right patients． Methods The concept of "Health Care Failure Mode and Effect analysis" was used to analyze the procedure of in-patients' oral administration,and adjust the system according to insecurity factors to improve the hospital oral administration system constantly． Results The systematic reconstruction of the oral administration improved nurses' and patients' satisfaction,reduced the error rate of in-patients' oral administration and improved the safety of oral administration． Conclusion The application of"Health Care Failure Mode and Effect analysis" to forward-looking analysis in-patient oral administration system,combined with the actual situation of our hospital to develop and implement plans are the guarantees of oral administration security.
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Objective To observe the effect of electroacupuncture(EA) of different acupoints on electroretinogram(ERG) and cerebral visual evoked potentials(VEP) in healthy subjects so as to evaluate the relative specificity of the function of acupoints.Methods A total of 33 healthy adult volunteers were observed in the present study.The subject was asked to lie on a testing bed for a while,two disk electrodes were respectively fixed to the suborbital region and the occiput(the crossing point,5cm apart from the right median line of the head and 5cm above the ear),and the reference electrode was fixed to the medial side of the earlobe for recording ERG and cerebral VEP separately.The testing room was asked to keep faint light during the whole recording process.A flash stimulation(frequency 1 Hz) was applied to the subject's eye(with a distance of about 50 cm between the light source and the tested eye,and the other eye was covered by an eyepatch).EA(0.5 Hz,0.2 ms and 3-4 V) was applied to Guangming(GB 37),Neiguan(PC 6) and Zusanli(ST 36) for 30 min respectively in different testing days(with the interval being 3 days at least).ERG and cerebral VEP were recorded by using Polygraphy(RM-6200).Results Following EA of Guangming(GB 37),Neiguan(PC 6) and Zusanli(ST 36),the changing values(increase and decrease) of the amplitude of b waves of ERG and P100 waves of cerebral VEP were(19.68?12.61)% and(12.84?14.08)%,(6.09?14.06)% and(5.61?8.01)%,(2.39?3.52)% and(5.43?8.22)%,respectively,while those of b waves of ERG and P100 waves of cerebral VEP of GB 37 were significantly bigger than those of PC 6 and ST 36(P
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Objective To investigate the efficacy and accuracy of quantitative computed tomography (QCT) in assessment of fracture healing. Methods Twenty-four healthy New Zealand rabbits were enrolled in the study and randomly divided into two groups, ie, Croup A (union model group, transverse fracture open created on mid-shaft of tibia and inter-fixed by kirschner wire) and Group B (non-union model group, transverse fracture with 5 mm defect on mid-shaft of tibia open created, then sealed with bone wax on fracture gap and medulla cavity, inter-fixed by kirschner wire). At 2, 4, 8 and 12 weeks, Kirschner wire was withdrawn and plain X-ray and QCT scanning were performed on the bilateral tibia. Then, rabbits were scarified and its bilateral tibia were desected and histologically examined. The result of X-ray and histological analysis was used as the "golden standard" for evaluation of fracture healing. Receiver operating characteristic curve (ROC) was used to analyze the evaluation performance of QCT. The corresponding segments of the contralateral healthy tibia were used as control to investigate the change of QCT parameters. Results In Group A, X-ray and histological analysis verified clear fracture line filled with irregular callus at 2 and 4 weeks but proved vague or vanishing fracture line and continuous and intact cortex of irregular callus at 8 and 16 weeks. In Group B, X-ray and histology analysis found clear fracture line with inactive ossification at 2 and 4 weeks but vague fracture line with scarce osteocyte and bone trabecula at 8 and 16 weeks. ROC analysis of QCT results showed the following results; (1) the areas under curve (accuracy) of material parameters including bone mineral density (BMD) and bone mineral content (BMC) were 0.781 and 0.750 respectively; (2) structure parameter-cross-sectional area (CSA) and the area under curve of cross-sectional moment of inertia (CSMI) were 0.781 and 0.469 respectively (P <0.05); (3) the areas under curve of the extending parameters bone strength indices (BSICSA) and CSMI bone strength indices ( BSICSMI) were 0. 913 and 0. 813 respectively (P < 0.05); (4) the area under curve (accuracy) of BSICSA, CSA and BMD were 0.905, 0.921 and 0.905 respectively (P<0.05). Conclusions QCT has potential in distinguishing fracture union and nonunion models in measurement of local fracture pattern. The screening parameters with more accuracy are BSICSA, CSA, BMD, which have advantages of accuracy and specialty in assessing fracture healing.