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Objective:To explore the surgical techniques and outcomes of closed reduction for geriatric subtrochanteric femoral fractures with certain radiological characteristics.Methods:A retrospective analysis was conducted in the 38 aged patients with subtrochanteric femoral fracture who had been treated at Department of Geriatric Orthopedics, Guangdong Provincial Hospital of Chinese Medicine from January 2015 to December 2019. There were 24 females and 14 males, aged from 62 to 95 years (average, 80.9 years). According to the Seinsheimer classification, there were one case of type ⅡB, 7 cases of type ⅡC, 18 cases of type ⅢA, 9 cases of type Ⅳ, and 3 cases of type Ⅴ. The time from injury to operation averaged 2.3 days (from 0.5 to 8.0 days). The fractures of this cohort were characterized by: ①The starting point of the medial fracture line was at the proximal end and the lesser trochanter separated. ②The fracture end was shortened and overlapped on the medial side and angled outward, showing a varus deformity. ③The alignment returned to normal after traction, with only partial lateral displacement left. Before fixation with proximal femoral nail antirotation (PFNA), all these patients were treated by closed reduction in a supine traction bed. In those whose reduction was unsatisfactory, a main nail was inserted or after the main nail was inserted reduction by leverage was performed through the screw blade incision. Intraoperatively, the quality of fracture reduction was evaluated according to the modified Baumgaertner assessment. Recorded were the patients’ operation time, intraoperative blood loss, fracture healing time, hip function and complications.Results:All the fractures achieved 100% of good to excellent reduction (38/38). The operation time ranged from 25 to 120 min (average, 55.6 min) and the intraoperative blood loss from 10 to 150 mL (average, 42.9 mL). This cohort of 38 patients was followed for 10 to 20 months (average, 15.3 months). All the fractures united after 3 to 8 months (average, 4.8 months). The Harris hip scores at the last follow-up ranged from 70 to 94 (average, 81.5). The follow-ups revealed no such complications as internal fixation failure, fracture re-displacement, malunion or nonunion.Conclusion:Closed reduction and PFNA fixation in a supine traction bed can lead to satisfactory clinical effects for the subtrochanteric femoral fractures with certain radiological characteristics in the aged patients.
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Objective To investigate the levels of activated Stat3 (p‐Stat3) and the expression levels of SOCS3 as well as their clinical significance and its impact on the pathogenesis ,progression ,and prognosis in patients with gastric cancer .Methods The levels of p‐Stat3 and SOCS3 were tested in 53 cases of gastric cancer tissues (test group) and 27 cases of adjacent non cancerous tis‐sues (control group) by immunohistochemistry (IHC) .The clinical pathological and follow up data were analyzed .Results The levels of activated p Stat3 were significantly higher in gastric cancer tissues than in non cancerous tissues .The levels of SOCS3 were lower in cancer tissues than in non cancerous control tissues (P<0 .05) .p‐Stat3 showed significantly different levels among TNM stages and tumor differentiation ,and the expression levels of SOCS3 were negatively associated with cancer invasion ,lymph node metastasis and TNM stages in cancer patients (P<0 .05) .Furthermore ,a negative correlation was observed between the levels of activated p‐Stat3 and SOCS3 in gastric cancer tissues (r= -0 .492 ,P<0 .05) .Kaplan Meier survival analyses indicated that the p‐tat3 levels were negatively correlated with total survival of gastric cancer patients ,the higher the levels of p‐Stat3 was ,the lower the total survival rate would be (χ2 = -5 .05 ,P<0 .05) .On the contrary ,the levels of SOCS3 showed a positive correlation with total survival (χ2 =10 .852 ,P<0 .05) .Conclusion Increased a p‐Stat3 and decreased expression of negative Stat3 regulator SOCS3 may play important roles in the development and progression of gastric cancer ,both of which would potentially serve as prognostic mark‐ers for gastric cancer .
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This article brieves the significance of the quality of medical records in the mode of basic medical insurance and argues that five aspects concerning quality control should be brought into focus on coordination with the auditing requirements on the medical records put forward by the medical insurance department.The faculty should be educated to become quality-conscious and legality-conscious and the awareness of medical records quality-profit should be imbedded into their minds.The quality control standards of medical records should be set up and the system of quality control,feedback,rewards and punishment should be improved.The monitoring and evaluation by the medical insurance department should be treasured and mutual communication should be enforced to further improve the quality of medical records.
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Thirty-two cases of calcaneodynia were treated with high-energy vibration wave combined with external application of Shuangbo Ointment (Group 1) and other 32 with high-energy vibration wave only (Group 2) as control. The results showed that the markedly effective rates of short-term treatment (3 weeks) and long-term treatment (3 months) were 56.25% and 84.37% in Group 2, and 81.25% and 93.75% in Group 1 respectively. It is suggested that high-energy vibration wave combined with external application of Shuangbo Ointment exerts a better effect for calcaneodynia, and can decrease the occurrence of hematoma and periosteum stripping induced by high-energy vibration wave.