Objective To explore the safety test and clinical efficacy evaluation of 3D printing image contrast technology model in Sanders type II (sanders II) calcaneal fractures. Methods Retrospective analysis of 46 cases of sandersII calcaneal fracture treated in Affiliated Hospital of Chengde Medical University from May 2014 to October 2021 was made. According to the preoperative plan, patients were divided into mirror image technique group (23 cases) and radiology technique group (23 cases), the measured data of scaphoid bone and fifth metatarsal bone of the affected side and the healthy side were compared by mirror image. The clinical effects were evaluated by preoperative, perioperative and follow-up indexes. Results The measured data of scaphoid bone and fifth metatarsal bone of the affected side and the contralateral side were compared in the mirror image technique group,there was no significant difference between the two groups (P>0.05), so it was safe to use the mirror image technique in preoperative planning. There were significant differences in pre-operative planning related cost, pre-operative planning related time and fracture reduction time between the two groups (P>0.05). All patients were followed up for 9-15 months with an average of (12.48±2.26) months. There was a significant difference in fracture healing rate between the two groups (P>0.05), and there was no significant difference in Maryland foot function between the two groups (P>0.05). Conclusion The application of 3D printing mirror image contrast technique in sandersII type calcaneal fracture is safe and reliable, and the clinical effect is definite, but it will increase the economic and time burden of patients.

Objective To explore the clinically significant cut-off value of serum anti-PLA2R antibody (sPLA2R-Ab) in adult idiopathic membranous nephropathy (IMN) in Baoding City. Methods A total of 285 patients who underwent renal needle biopsy and sPLA2R-Ab detection in Baoding First Central Hospital from January 2018 to December 2021 were included. The patients were divided into IMN group, secondary membranous nephropathy (SMN) group and other groups. The level of sPLA2R-Ab was compared between the groups; the correlation between sPLA2R-Ab level and other clinical indicators in IMN patients was analyzed; logistic regression was applied to identify the risk factors of IMN; the diagnostic value of sPLA2R-Ab for IMN was analyzed by ROC curve, and Youden index was calculated to obtain the optimal cut-off value of sPLA2R-Ab for IMN diagnosis. Results The level of sPLA2R-Ab in IMN group was significantly higher than that in SMN group and other groups(P<0.05). In IMN group, sPLA2R-Ab was negatively correlated with total protein and albumin(P<0.001), it was positively correlated with 24h urinary protein, serum creatinine and cholesterol(P<0.05). ROC curve showed that the cut-off value of sPLA2R-Ab in the diagnosis of IMN patients was 3.315RU/mL, the corresponding Youden index was the highest (0.651), the sensitivity was 79.4%, the specificity was 85.7%, the AUC was 0.829, P<0.001. Conclusion sPLA2R-Ab is associated with the activity of IMN disease. The cut-off value of SPLA2R-AB for differentiating IMN from non-IMN patients is 3.315RU/mL, which can improve the early diagnosis rate of IMN.

Objective To compare the effects of DSA-guided Fogarty balloon catheter removal and incision exploration in the treatment of arterial crisis combined with thrombosis. Methods Analysis rstrospectively the clinical data of 35 cases who had vascular crisis after replantation of severed limbs and diagnosed with combined thrombosis by high-frequency ultrasound from September 2012 to May 2020 in the Affiliated Hospital of Chengde Medical University. According to the surgical method, the cases divided into minimally invasive group (fogarty balloon catheter thrombectomy under DSA guidance, 12 cases) and open group (incision and exploratory surgery, 23 cases). A comparative study of various indicators before, during and after the operation. Results There was no statistically significant difference in general information between the two groups at admission (P>0.05), and they were comparable; the time to vascular repatency, intraoperative operation time, and intraoperative blood loss in the minimally invasive group were significantly lower than those in the open group (P<0.05); the postoperative re-embolization rate and postoperative amputation rate of the minimally invasive group were significantly lower than those of the open group (P<0.05); there was no significant difference between the two groups in the rate of good limb function at 9 months postoperative follow-up (P>0.05); the hospitalization medical expenses open group was significantly lower than the minimally invasive group (P>0.05). Conclusion DSA-guided Fogarty balloon catheter removal for arterial crisis combined with thrombosis can avoid secondary damage to the repair area of the broken end, with low incidence of complications and definite early curative effect, but will increase medical costs.

Objective: To investigate the clinical effects of restrictive fluid resuscitation and conventional fluid resuscitation on patients with shock and trauma induced coagulopathy (TIC). Methods: 78 patients with shock and TIC were randomly divided into routine treatment group (n=39) and restriction group (n=39). Conventional fluid resuscitation was used in routine treatment group, while restrictive fluid resuscitation was used in restriction group. The blood gas analysis indexes, coagulation function, incidence of complications and survival rate of patients in 2 groups were compared. Results: 60 min and 120 min after resuscitation, the pH and PaO ₂ of patients in restriction group were obviously higher than routine treatment group, but the PaCO ₂, PT, APTT, TT were obviously lower (P<0.05). 24h after resuscitation, the incidence of acute respiratory distress syndrome, disseminated intravascular coagulation and multiple organ failure of patients in restriction group were obviously lower than routine treatment group (P<0.05); the survival rated of restriction group 1 week after resuscitation was obviously higher than routine treatment group (P<0.05). Conclusions: Treating shock and TIC patients with restrictive fluid resuscitation can improve the blood gas analysis indexes and coagulation function better, and reduce complications effectively, so it is worthy of popularizing application in clinic.