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Objective@#To explore the cross classification of tibial plateau fractures combined with avulsion fracture of medial femoral condyle.@*Methods@#The 16 patients were retrospectively analysed as an observation group who had been treated at Department of Lower Limbs, Sichuan Orthopaedic Hospital for tibial plateau fracture and avulsion fracture of the medial condyle of the same femur from January 2015 to December 2018. They were 9 males and 7 females, aged from 27 to 78 years (average, 51.5 years). By the Schatzker classification, there were 2 cases of type Ⅰ, 8 cases of type Ⅱ, 3 cases of type Ⅲ and one case of type Ⅳ; by the cross classification, there were 10 cases of type Ⅰe, one case of type Ⅱe and 2 cases of type Ⅲe and 3 cases of type Ⅰv. The 332 patients were included as a control group who had been treated at the same department for simple tibial plateau fracture from January 2010 to December 2015. The imaging data of the 2 groups were compared to find out the charateristics of cross type distribution; the widened distance of the lateral tibial plateau, collapse depth of the tibial plateau, separation of avulsion fracture of medial femoral condyle, maximum clearance of the medial knee and eversion angle of the tibial plateau were investigated in the patients with cross types e and Ⅰv in the observation group.@*Results@#In the observation group, the widened distance of the lateral tibial plateau averaged 7.18 mm, the collapse depth of the tibial plateau 8.74 mm, the separation of avulsion fracture of medial femoral condyle 3.44 mm, the maximum clearance of the medial knee 7.77 mm, and the eversion angle of the tibial plateau 87.03°. There was a significant difference in the cross type distribution of tibial plateau fractures between the 2 groups (P=0.002). In the observation group, the average widened distance of the lateral tibial platea for the 13 type e patients (8.49±4.26 mm)was significantly larger than that for the 3 type Ⅰv patients (1.51±2.11 mm) (t=2.706, P=0.017).@*Conclusion@#The cross classification of tibial plateau fractures with avulsion fracture of mediall condyle of the same femur may result mainly in types e and type Ⅰv. The widened distance of lateral tibial plateau helps distinction between types e and type Ⅰv.
ABSTRACT
Objective To explore the cross classification of tibial plateau fractures combined with avulsion fracture of medial femoral condyle.Methods The 16 patients were retrospectively analysed as an observation group who had been treated at Department of Lower Limbs,Sichuan Orthopaedic Hospital for tibial plateau fracture and avulsion fracture of the medial condyle of the same femur from January 2015 to December 2018.They were 9 males and 7 females,aged from 27 to 78 years (average,51.5 years).By the Schatzker classification,there were 2 cases of type Ⅰ,8 cases of type Ⅱ,3 cases of type Ⅲ and one case of type Ⅳ;by the cross classification,there were 10 cases of type Ⅰe,one case of type Ⅱe and 2 cases of type Ⅲ e and 3 cases of type Ⅰv.The 332 patients were included as a control group who had been treated at the same department for simple tibial plateau fracture from January 2010 to December 2015.The imaging data of the 2 groups were compared to find out the charateristics of cross type distribution;the widened distance of the lateral tibial plateau,collapse depth of the tibial plateau,separation of avulsion fracture of medial femoral condyle,maximum clearance of the medial knee and eversion angle of the tibial plateau were investigated in the patients with cross types e and Ⅰv in the observation group.Results In the observation group,the widened distance of the lateral tibial plateau averaged 7.18 mm,the collapse depth of the tibial plateau 8.74 mm,the separation of avulsion fracture of medial femoral condyle 3.44 mm,the maximum clearance of the medial knee 7.77 mm,and the eversion angle of the tibia1 plateau 87.03°.There was a significant difference in the cross type distribution of tibial plateau fractures between the 2 groups (P =0.002).In the observation group,the average widened distance of the lateral tibial platea for the 13 type e patients (8.49 ± 4.26 mm)was significantly larger than that for the 3 type Ⅰv patients (1.51 ± 2.11 mm) (t =2.706,P =0.017) Conclusion The cross classification of tibial plateau fractures with avulsion fracture of mediall condyle of the same femur may result mainly in types e and type Ⅰv.The widened distance of lateral tibial plateau helps distinction between types e and type Ⅰv.
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Objective: to analyse the effects of combined acupuncture anesthesia on surgical dosage and serum interleukin-4 [IL-4], interleukin-10 [IL-10] of pneumonectomy patients
Study Design: a randomised controlled trial [RCT]
Place and Duration of Study: lanzhou University Second Hospital, Lanzhou, China, from January 2016 to November 2017
Methodology: a total of 110 patients undergoing pneumonectomy were randomly divided into group A and group B, with 55 cases in each group. Group A was treated with combined 2Hz acupuncture anesthesia, while group B was treated with combined 2Hz/100Hz acupuncture anesthesia. The additional propofol, fentanyl dosage, and changes in heart rate and systolic blood pressure 5 min before and during extubation were compared between the two groups. The serum IL-4 and IL-10 levels were measured 10 minutes after skin incision and 24 hours after surgery using ELISA. Pain was rated by visual analogue scale [VAS] at 24 hours after surgery
Results: there was no statistically significant difference between group A and group B in the intraoperative additional propofol and fentanyl dosages [p=0.541 and 0.719, respectively]. There is no statistical difference in heart rate and systolic blood pressure between group A and group B at 5 minutes before and during extubation [p=0.151, 0.660 and 0.734, 0.528, respectively]. There is no statistical difference between group A and group B in serum IL-4 and IL-10 levels 10 minutes after surgical incision [p=0.916 and 0.841, respectively]. However, serum IL-4 and IL-2 levels in group A are statistically lower than that of group B at 24 hours after surgery [all p<0.001]. The VAS score at 24 hours after surgery in group A was 2.44 +/- 0.71 points, which was significantly lower than that of group B [3.82 +/- 0.77 points, p<0.001]
Conclusion: combined 2 Hz, 2 Hz/100 Hz acupuncture anesthesia need few anesthetic dosages of propofol and fentanyl to stabilise the patient's blood pressure and heart rate when intubated under general anesthesia; but combined 2 Hz acupuncture anesthesia can reduce IL-4 and IL-10 levels during surgery stress to a greater extent than the latter, and can effectively lower patients' serum IL-4, IL-10 expression after surgery
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OBJECTIVE To investigate the restrained factors in the disposal of medical dispute caused by nosocomial infection and try to find out the method to solve the problem. METHODS The several restrained factors in the disposal of medical dispute about nosocomial infection were enumerated and analyzed. RESULTS There are several restrained factors in the disposal of medical dispute about nosocomial infection according to law. First, nosocomial infection can not be died out, and medical dispute about nosocomial infection will exist for ever as a result of the specialty of supply of medical service. Secondly, current legal system construction of nosocomial infection management in our country is in the stage of being established and consummated step by step. Determinant criteria of medical negligence behavior are not perfect. Feasibility of part of the actual rules and standard in nosocomial infection is not good. Thirdly, collecting evidence is very difficult in some medical dispute caused by nosocomial infection . It is restricted by hospital condition, medical cost and medical documents. Because of the restrained factors mentioned above, when nosocomial infection occurs, medical workers concerned can not find or confirm the reason of infection in most cases. Then hospital has to compensate patients for loss in order to make concessions to avoid trouble. CONCLUSIONS We make following suggestions for the status. First, we should strengthen legal system construction about nosocomial infection, and safeguard both of hospital and patients′ interests . Secondly, insurance system of medical risk should be perfected. Thirdly, medical workers should abide by rules of operation. Fourthly, we can not hide the truth when nosocomial infection occurs. Fifthly, we must fulfil the "attention duty" in order to reduce medical dispute.
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OBJECTIVE To overcome shortcomings in use of bed sheet,and to improve it for examining bed.METHODS Based on the working principle of the reel toilet paper and industrial drive belt,a reel device for(disposable) whole bed sheet was designed,and used on the bed examining more than 300 times.(RESULTS) The new designed reel aevice with disposable whole bed sheet was operated easy and safely,with decreased cost and(contamination) in use.It could alleviate infection opportunity in favor of control againt hospital infection and(environmental) protection.(CONCLUSIONS) The device can mount on any size of examining bed and widely accept for use.
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OBJECTIVE To ascertain the causes of unreported hospital infection in our hospital and apply countermeasures. METHODS To adopt investigation way to review and analyze 34 694 hospital files in our hospital from Aug 2002 to Jul 2004. RESULTS From them 1164 cases had experienced hospital infection,264 were unreported,the monthly unreported rate decreased from 52.50% to 0;the yearly unreported rate decreased from 36.17% to 10.67%. CONCLUSIONS The unreported reason is because the relevant staff lack infection knowledge,the control and supporting system isn′t so efficient.So the key to reduce the missing report rate is to enhance the awareness of the hospital infection control among the staff in hospital,to strengthen communication and cooperation,and to implement the administrative regulation.