Objective To observe the effectiveness of reduction and fixation by the improved elbow anteromedial approach in treatment of ulna coronoid process fracture. Methods Between January 2010 and December 2014, 13 patients with the ulna coronoid process fracture were treated with reduction and fixation by the improved elbow anteromedial approach. There were 10 males and 3 females with an average age of 37.2 years (range, 18-57 years). Five cases were caused by traffic accident, 7 cases by falling injury from height, and 1 case by object impact injury. Seven cases were the terrible triad of the elbow, 4 cases were the ulna coronoid process and radial head fractures, 1 case was the proximal radius and ulna fractures, and 1 case was the ulna coronoid process and distal radius fractures. According to Regan-Morrey classification criteria, the ulna coronoid process fracture was rated as type Ⅱ in 2 cases and as type Ⅲ in 11 cases. According to O’Driscoll classification criteria, 10 of the 13 cases were anterior coronoid fracture (8 cases of type Ⅱb, 2 of type Ⅱc), and 3 of basal fracture. The operation time, amount of intraoperative bleeding, postoperative complications, range of motion (ROM) of the elbow joint, Mayo elbow function index (MEPI) score and fracture healing time were recorded. Results The average operation time was 38.7 minutes (range, 30-55 minutes), and the average amount of intraoperative bleeding was 109.3 mL (range, 90-160 mL). All incisions healed at stage Ⅰ. There was no iatrogenic vascular or nerve injury. All patients were followed up 13-24 months (mean, 16.9 months). All fractures achieved clinical healing. The average healing time was 11.2 weeks (range, 8-16 weeks). There were 2 cases of heterotopic ossification. At last follow-up, the ROM of elbow flexion was 119-145° (mean, 132.4°); the ROM of elbow extension was –8-15° (mean, 7°). The ROM of forearm pronation was 68-90° (mean, 78.6°), and the ROM of forearm supination was 76-90° (mean, 84.3°). At last follow-up, the MEPI score was 70-100; and 9 cases were excellent, 3 cases were good, and 1 case was fair. The excellent and good rate was 92.3%. Conclusion Improved elbow anteromedial approach for the ulna coronoid process fracture can not only avoid the injuries of surrounding blood vessels and nerves, but also perform fracture reduction and fixation under direct vision. It is a safe, simple, and effective treatment method for the ulna coronoid process fracture.
Objective To systematically review and analyze the publication of clinical guidelines and consensuses on day surgery in Chinese-language journals, summarizing achievements, shortcomings, and future development directions. Methods A systematic literature search was conducted on China National Knowledge Infrastructure, Wanfang, SinoMed, and China Medical Journal Full-text Database to collect day surgery clinical guidelines and consensuses published up to December 31, 2025, followed by systematic summarization and analysis. Results A total of 55 clinical guidelines and consensuses were ultimately included, among which 4 were clinical guidelines. No day surgery clinical guidelines or consensuses were published before 2015, with the highest number of publications in 2019. Based on content coverage and professional fields, these day surgery clinical guidelines and consensuses included 7 comprehensive management categories, 32 specialty/specific surgical procedure categories, 13 anesthesia, rapid recovery, and nursing categories, and 3 medical record writing categories. By issuing institution/academic entity, these clinical guidelines or consensuses included 38 from national-level industry associations, 11 from large medical institutions, and 5 from provincial/municipal/county-level professional committees. Among them, 13 day surgery clinical guidelines and consensuses reported recommendation levels and strengths. Most guidelines and consensuses were formulated by referencing advanced day surgery practices abroad while integrating China’s national conditions and operational experiences of medical institutions. Conclusions Evidence from Chinese-language journals shows that clinical guidelines and consensuses building for day surgery in China have achieved certain results, forming a basic framework for guiding practice. However, there are still challenges in terms of system integrity, implementation effectiveness, and scientific research support.
The European Society of Cardiology (ESC) released the "2024 ESC guidelines for the management of elevated blood pressure and hypertension" on August 30, 2024. This guideline updates the 2018 "Guidelines for the management of arterial hypertension." One notable update is the introduction of the concept of "elevated blood pressure" (120-139/70-89 mm Hg). Additionally, a new systolic blood pressure target range of 120-129 mm Hg has been proposed for most patients receiving antihypertensive treatment. The guideline also includes numerous additions or revisions in areas such as non-pharmacological interventions and device-based treatments for hypertension. This article interprets the guideline's recommendations on definition and classification of elevated blood pressure and hypertension, and cardiovascular disease risk assessment, diagnosing hypertension and investigating underlying causes, preventing and treating elevated blood pressure and hypertension. We provide a comparison interpretation with the 2018 "Guidelines for the management of arterial hypertension" and the "2017 ACC/AHA guideline on the prevention, detection, evaluation, and management of high blood pressure in adults."