[Treatment of open fracture of lower limb in high altitude area].

OBJECTIVE: To explore the treatment methods and experience of open fracture of lower limb in high altitude area. METHODS: From January 2016 to January 2021, 62 patients with open fractures of lower limbs were treated by staged surgery with the concept of injury control orthopedics, emphasizing wound treatment and combining various fracture fixation methods. There were 51 males and 11 females, ranging in age from 14 to 59 years old, with a mean of (37.2±12.3) years old; and the course of disease ranged from 7 to 59 days, with a mean of (23.7±15.5) days. According to Gustilo Anderson classification, there were 14 cases of typeⅠ, 24 cases of typeⅡ, 14 cases of typeⅢA, 8 cases of typeⅢB and 2 cases of typeⅢC. The fracture repair and wound healing were observed, and the clinical efficacy was evaluated by Johner-Wruhs evaluation standard. RESULTS: Fifty-five patients were followed up, and the duration ranged from 4 to 36 months, with a mean of (14.7±8.5) months, and 7 cases were lost to follow-up. According to Johner-Wruhs evaluation criteria, 33 cases got an excellent result, 16 good, 4 poor and 2 bad. The wound healing was poor in 2 cases, partial necrosis of Achilles tendon in 1 case, nonunion of fracture in 1 case and delayed healing of fracture in 2 cases. CONCLUSION: It is an effective method to treat the open fracture of lower extremity in high altitude area to pay attention to the management of soft tissue injury, the management of wound moisturizing, staged operation of fracture and full protection of blood supply at the fracture end. Paying attention to the treatment of soft tissue injury and the management of wound moisturizing, staged operation of fracture and full protection of blood supply at the fracture end are effective methods for the treatment of open fracture of lower limbs in high altitude areas.

[Diagnosis of eco-environmental quality in the Keluke Lake basin, China]. / å¯é²å ‹æ¹–æµåŸŸç”Ÿæ€çŽ¯å¢ƒè´¨é‡è¯Šæ–­.

In order to clarify the eco-environmental quality and its evolution characteristics of Keluke Lake basin, we selected 15 factors of physical geography, meteorology, land use/cover and social economy using comprehensive investigation, remote sensing interpretation and inversion, statistical analysis and other technical means, based on the relevant theories of environmental ecology. We used factor analysis and entropy method to calculate the index weight, constructed watershed soil quality model and ecological environment quality diagnosis model, and analyzed the changes of soil and eco-environmental quality in the Keluke Lake basin in 2000, 2005, 2010 and 2015. The results showed that the average eco-environmental quality in four periods was 21, 47, 54, and 72, showing a stable upward trend. The eco-environmental quality level changed from poor to good, while soil quality was at the middle level. Spatially, the eco-environmental quality of the northern mountainous area, the downstream wetland and the surrounding area of the river improved significantly. The change of eco-environmental quality was a result of human activities and natural factors. Soil quality and lake area were key factors indicating the eco-environment of the Keluke Lake basin. The minimum ecological water demand of the Keluke Lake was the basic guarantee to maintain the benign development of the eco-environment of the lake basin.