Objective To investigate the surgical treatment method and the curative effect of tibial nonunion with superficial peroneal vascular fascia pedicel tibiofibular periosteal flap. Methods From January 1996 to December 2008, 18 cases of tibial nonunion were treated with superficial peroneal vascular fascia pedicel tibiofibular periosteal flap, interlockingintramedullary nail ing and cancellous bone graft of distal tibial. There were 14 males and 4 females, with an average age of 32.5 years old (range, 24-67 years old). Fracture site was middle in 10 cases and distal in 8 cases. Primary injury cause included 12 cases of traffic accident and 6 cases of bruise. The tibial nonunion reasons were manual reduction and plaster immobil ization in 8 cases, small spl int immobil ization in 4 cases, intramedullary nail fixation in 2 cases (no bone graft), plate fixation in 4 cases (including 3 cases of plate fixation and free il iac bone graft). Nonunion occurred after the first surgery. The time from nonunion to operation was 8 to 16 months, with an average of 10.5 months. The size of periosteal flap was 7 cm × 5 cm and distal tibial cancellous bone graft volume was 5-10 g. Results All incision achieved heal ing by first intention after operation without flap necrosis and infection. All patients were followed up 6-36 months with an average of 20.8 months. All tibial nonunion healed 5-7 months after operation. According to Johner-Wruh scoring, the results were excellent in 14 cases, good in 3 cases, and fair in 1 case; the excellent and good rate was 94.4%. Conclusion Superficial peroneal vascular tibiofibularfascia pedicel tibiofibular periosteal flap and interlocking intramedullary nail ing can attain good results in treating nonunion of tibia and fibula because of being stable internal fixation and promoting the heal ing of nonunion.
目的 分析幽门螺杆菌(Helicobacter pylori, HP)根除治疗失败相关因素，为有效根除Hp提供建议和决策。 方法 对2005年5月-2008年12月经胃镜检查确诊的慢性胃炎或消化性溃疡，且Hp检测阳性并行含质子泵抑制剂三联或四联治疗的患者103例进行研究。治疗结束至少4周后，用14C呼气试验评估Hp是否成功根除，根据测试结果分为治疗失败组33例及治疗成功组70例。运用统一标准的调查表对每位患者进行相关因素调查，就调查表所涉及的因素在根除失败组与成功组间采用单因素及多因素Logistic回归进行分析。 结果 通过单因素分析依从性和饮酒在两组之间有统计学意义(P＜0.05)。Logistic多因素分析发现，依从性差是根除失败的独立危险因素。 结论 依从性差是治疗失败十分重要的影响因素。