Locking plate external fixation combined with membrane induction technology for the treatment of open and comminuted tibial fractures with bone defects / 中国骨伤

OBJECTIVE@#To explore clinical effect of locking plate external fixation combined with membrane induction technology in treating open and comminuted tibial fractures with bone defects.@*METHODS@#Totally 92 patients of open and comminuted tibial fractures with bone defects were chosen form January 2018 to July 2019, and randomly divided into external fixation group and internal fixation group, 46 patients in each group. In external fixation group, there were 29 males and 17 females, aged from 25 to 62 years old, with an average of (37.45±10.92) years old;according to AO classification, 15 patients were type A, 22 patients were type B and 9 patients were type C;according to Gustilo classification, 21 patients were typeⅡ, 10 patients were type ⅢA, 10 patients were type ⅢB, 5 patients were type Ⅲ C;treated by fracture reduction with locking plate external fixation. In internal fixation group, there were 31 males and 15 females, aged from 23 to 60 years old, with an average of(36.88±10.64) years old;according to AO classification, 18 patients were type A, 20 patients were type B and 8 patients were type C; according to Gustilo classification, 22 patients were typeⅡ, 11 patients were type ⅢA, 7 patients were type ⅢB, 6 patients were type Ⅲ C;treated by traditional open reduction with plate internal fixation. Operation time, intraoperative blood loss, incision length, hospital stay, fracture healing time and lower limb full weight-bearing time and postoperative complications between two groups were observed and compared, bone mineral density, osteocalcin, blood calcium and phosphorus before operation and 1 month after operation.@*RESULTS@#All patients were followed up from 12 to 18 months with an average of (14.92±2.46) months. Operation time, intraoperative blood loss, incision length, hospital stay, fracture healing time and lower limb full weight-bearing time of external fixation group were significantly better than that of internal fixation group(@*CONCLUSION@#Locking plate external fixation combined with membrane induction technology in treating open and comminuted tibial fractures with severe post-traumatic bone defects has advantages of less trauma, reliable fixation, shorter fracture healing time, and could improve bone metabolic activity with less postoperative complications.

Diagnosis and treatment strategy for advanced severe lung cancer / 中国实用内科杂志

Advanced severe lung cancer means the stage IIIB, IIIC, and IV lung cancer patients with a PS score of 2 to 4 points due to various related causes of lung cancer itself or the complication of anti-tumor drugs, with a high probability of benefiting from the existing systemic anti-tumor treatments. The diagnosis and treatment strategies emphasize the implementation of minimally invasive dynamic monitoring mutation targets and curative effects. Every drug that is useful to the patient should be used as possible, and making the best use of every drug as possible with the help of respiratory support therapy. Specific treatment concepts include combination therapy,alternating medication, paying equal attention to systemic therapy and local therapy, PS score assessment, upgrading and downgrading of drug use, and simultaneous treatment of cancer and lung itself.