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Objective To evaluate the effect of fast-track TKA upon the recovery time and degree of satisfaction of the patients.Methods 208 patients with primary osteoarthritis between 2013 and March 2015 were randomly divided into 2 groups.In fast-track TKA group was established in peri-operative analgesia,blood management,postoperative anticoagulation,surgical skill and mitigation of perioperative stress.In TKA group,conventional surgical management mode was followed.Identical discharge standards were established for patients in 2 groups to evaluate the recovery time.The patients' degree of satisfaction at postoperative 2 weeks was assessed by numerical rating scale (NRS).The degree of satisfaction about acquisition of preoperative information,degree of satisfaction about postoperative analgesia and postoperative function were statistically compared between 2 groups.Postoperative complication,blood transfusion rate,infectious events within postoperative 3 months,thrombosis-related events,re-operation and death were recorded.Results In fast-track TKA group,the mean discharge time was (2.3±1.2) d,significantly shorter compared with (4.7±5.1) d in TKA group.The mean NRS score in fast-track TKA group was 9.8±0.5 and 9.1±1.4 in TKA group.In fast-track TKA group,the mean scores of the degree of satisfaction about acquisition of preoperative information,degree of satisfaction about postoperative analgesia and postoperative function were 27.7±7.3,9.8± 1.7 and 9.6± 1.3,significantly higher than 15.5±10.1,9.2±2.2 and 8.7±1.8 in the TKA group.In fast-track TKA group,postoperative blood transfusion rate was 3.9％,considerably lower than 11.4％ in TKA group.Conclusion Fast-track TKA can shorten the length of hospital stay,not increase the mortality rate and postoperative complication,accelerate the recovery of daily activity and effectively enhance the degree of satisfaction of the patients.
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Objective To explore the best way and the security of hypertrophic scar treatment by surgery combined with isotopic 90 Sr-90 Y or triamcinolone acetonide.Methods Hypertrophic scar of rabbit ears were divided into direct treatment group (Group A received 90 Sr-90Y irradiation,Group D received triamcinolone acetonide),two days 90 Sr-90 Y irradiation after surgery repair group (Group B),one week treatment after surgery repair group (Group C received 90Sr-90 Y irradiation,Group E received triamcinolone acetonide),saline injection group (Group F received saline directly,Group G received saline injection after surgical repair one week later),Group H received nothing,and then the histological changes were compared in each group.Results The 90Sr-90 Y exposure groups (Groups A,B,C) and triamcinolone acetonide injection groups (Groups D and E),the number of fibroblasts,collagen fiber surface density,microvessel counts and α-SMA-positive particle optical density values were significantly lower than the saline groups (Groups F,G) and blank control group.The most obvious group was Group B; Groups A,C,D,and E were not statistically significant.The number of melanoma cells of 90Sr-90Y exposure group (Groups A,B,and C) was significantly lower than other groups,with statistically significant difference.Atypical cells were not found in 90Sr-90 Y applicator exposure group.Conclusions Isotope 90 Sr-90 Y and triamcinolone acetonide inhibits the proliferation of the rabbit ear hypertrophic scar,the scar tissue fibrosis is reduced significantly,but there is no significant difference between the two effects.Early isotope 90 Sr-90 Y intervention on hypertrophic scar can achieve better results.Hypertrophic scar by isotope 90 Sr-90 Y radiation is easy to cause depigmentation,but generally does not cause cancer.
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Objective To investigate the clinical efficacy of biological dressing A covering bandage of Ⅲ° burn wounds given comprehensive treatment including dermabrasion.Methods For patients of non Ⅲ° ° burn wounds (deep Ⅱ ° and partial superficial Ⅲ ° wounds),28 cases in the treatment group,were given improved dermabrasion with tangential excision plus thin layer of skin graft from the body,the wounds were covered with biological dressing A bandage.21 patients in the control group were treated by traditional tangential excision,escharectomy and self-skin grafting.The clinical treatment effect was observed and compared between the two groups.Results The wounds were healed 2 ～ 3 weeks after surgery in treatment group,the cure rate of burns in patients with a total area of 40％ ～ 50％ TBSA was 99％,and after treatment the scar formation significantly reduced,self-donated skin significantly reduced,the hospital stay and postoperative recovery time of the patients were significantly shorter,patients were easier to accept.In the control group,the operation time was longer,the blood loss was more,the wounds had more scar healing wounds.The wound healing time of the treatment group was (14.8 ± 1.8) d,which was significantly shorter than (19.4 ± 3.0) d of the control group (P ＜ 0.05).Conclusion The improved grinding A scab plus biological dressings covering bandage has the advantages of simple operation,light damage,less complications,need less skin,to maximize retention of healthy tissue,wound healing speed up,healing scar lessened.
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[Objective] The objective of the study was to determine the clinical and radiological outcomes of cervical interbody fusion using ROI cages. [Methods] Patients showing degenerative cervical mono- or bi-level pathology were prospectively included. Using AP and lateral radiographs, segmental height of the treated segments was determined quantitatively. Cage characteristics were described qualitatively. Clinical data such as the neck disability in-dex(NDI), numeric rating scale(NRS) were col ected at al time points .[Results] The scores of NDI, NRS were decreased gradual y, and stable after half year;but they were respectively reduced to 8.64 and 1.57 from 23.32 and 8.93, with difference of statistical meaning. The intervertebral angle increased af-ter operation, then decreased gradual y and was stable after half year, was 3.6 °after 1 year. The intervertebral height was maximum after operation, then re-duced gradual y, and was 5.32mm or so after 1 year. 16 patients were al cured after 1 year, with short fusion rate reaching 100%. [Conclusions] The clini-cal and radiological short-term outcome of anterior cervical discectomy and fusion using ROI cage are excel ent.