Curative effect of percutaneous screw-rod system combined with sacroiliac screw internal fixation in the treatment of types II-IV fragility fracture of the pelvis / 中华创伤杂志

Objective:To compare the effect of percutaneous screw-rod system combined with sacroiliac screw internal fixation and non-operation of type II-IV fragility fracture of the pelvis (FFP).Methods:A retrospective multicentral cohort study was performed to analyze the clinical data of 74 patients with FFP treated in Jiangjin Central Hospital of Chongqing and Hechuan People′s Hospital of Chongqing from January 2017 to June 2021, including 23 males and 51 females, aged 62-95 years [(79.3±7.3)years]. A total of 41 patients received non-surgical treatment (non-operation group). and 33 patients received percutaneous screw-rod system combined with sacroiliac screw internal fixation (operation group). The time to get out of bed, visual analog scale (VAS) and Majeed score on admission and at 1, 3, 6, 12 months after treatment, fracture healing time and complications were evaluated in the two groups.Results:Except for 9 patients who died at 3-9 months after treatment, the remaining patients were followed up for 12-24 months [(13.5±3.2)months]. The time to get out of bed was (11.4±2.8)days in operation group and was (67.4±4.4)days in non-operation group ( P<0.01). The VAS and Majeed score at 1, 3, 6 and 12 months after treatment were significantly improved in both groups compared with those on admission (all P<0.05). There was no significant difference in VAS and Majeed score between the two groups on admission (all P>0.05). The VAS was (3.2±0.7)points in operation group compared to (4.2±0.8)points in non-operation group at 1 month after treatment, and was (1.8±0.5)points in operation group compared to (2.9±0.7)points in non-operation group at 3 months after treatment (all P<0.01). The Majeed score was (56.0±2.4)points in operation group compared to (40.4±2.7)points in non-operation group at 1 month after treatment; the score was (77.3±2.6)points in operation group compared to (57.7±4.2)points in non-operation group at 3 months after treatment; the score was (86.5±1.8)points in operation group compared to (79.6±2.8)points in non-operation group at 6 months after treatment (all P<0.01). In contrast, the two groups had no statistically significant difference in VAS at 6 months and 12 months after treatment and Majeed score at 12 months after treatment (all P>0.05). There was no statistically significant difference in the fracture healing time between the two groups ( P>0.05). There was no statistically significant difference in the incidence of complications related to fixation methods between the two groups ( P>0.05). The incidence of bed-related complications was 24.2% (8/33) in operation group and was 51.2% (21/41) in non-operation group ( P<0.05). The 1-year fatality rate was 3.0% (1/33) in operation group and 19.5% (8/41) in non-operation group ( P<0.05). Conclusion:Compared with non-operative treatment, percutaneous screw-rod system combined with sacroiliac screw internal fixation in the treatment of type II-IV FFP can allow early off-bed movement, effectively relieve pain, improve quality of life of the patients, and reduce complication rate.

Comparative study of lateral position and half lithotomy position in Asian proximal femur intramedullary nail antirotation system internal fixation for treatment of elderly patients with femoral inter-trochanteric fractures / 中华创伤杂志

Objective:To compare the therapeutic effect of lateral position and half lithotomy position in Asian proximal femur intramedullary nail antirotation system (PFNA-II) for treating the elderly patients with femoral intertrochanteric fractures.Methods:A retrospective case control study was made on 141 patients with femoral intertrochanteric fractures admitted to Jiangjin Central Hospital from January 2016 to September 2017, including 54 males and 87 females, aged 65-99 years (mean, 80.4 years). According to AO classification, there were 42 patients with type A1 fractures, 88 with type A2 and 11 with type A3. Of all, 74 patients were stabilized by PFNA-II internal fixation in lateral position (lateral position group) and 67 patients by PFNA-II internal fixation in half lithotomy position (half lithotomy position group). The postural placement time, total incision length, operative time, intraoperative blood loss, fluoroscopy frequency, tip-apex distance, reduction quality, fracture healing time, postoperative complications and Harris hip function at 12 months after surgery were compared between the two groups.Results:All patients were followed up for 12-18 months (mean, 12.5 months), except that 13 patients were lost after 9 months, an average of 12.5 months. There were no statistically significant differences in postural placement time, operative time, fracture healing time, and Harris hip score between the two groups ( P>0.05). While significant differences were seen between lateral position group and half lithotomy position group regarding the incision length [(6.5±1.3)cm vs. (7.5±1.5)cm], intraoperative blood loss [(84.3±3.1)ml vs. (90.4±3.9)ml], fluoroscopy frequency [(13.1±1.9)times vs. (11.2±1.2)times], tip-apex distance [(20. 6±2.2)mm vs. (24.4±1.8)mm], good rate of reduction quality (80% vs. 85%) and implant related complications (5% vs. 2%) ( P<0.05 or 0.01). Conclusion:For treatment of elderly patients with intertrochanteric fractures, compared to the lateral position, the half lithotomy position in PFNA-II internal fixation can reduce frequency of fluoroscopy, improve quality of fracture reduction and reduce implant-related complications.

Efficacy of different operative positions on Asian proximal femoral anti-rotation intramedullary nail for femoral intertrochanteric fracture in the elderly / 中华创伤杂志

Objective To compare the clinical efficacy between supine position and latericumbent position on Asian proximal femoral nail anti-rotation (PFNA-Ⅱ) fixation for femoral intertrochanteric fracture in elderly patients.Methods A retrospective case control study was conducted to analyze the clinical data of 128 patients with intertrochanteric fractures admitted from January 2016 to January 2017.There were 49 males and 79 females,aged 65-100 years,with an average of 83.2 years.According to AO classification of fracture,there were 27 cases of type A1,82 cases of type A2,and 19 cases of type A3.The patients were divided in to supine position group at traction bed (66 cases) and latericumbent position group at regular bed (62 cases) according to the operative position.The two groups were treated with Asian PFNA-Ⅱ internal fixation.The position time,incision length,operation time,intraoperative blood loss,ambulation time without load,fracture healing time,and Harris score of hip function at the last follow up were compared between the two groups.Complications were recorded.Results All patients were followed up for 12-18 months,with an average of 13.5 months.There were no significant differences between the two groups inambulation time without load,fracture healing time,and Harris score of hip joint function (P ＞ 0.05).In the supine position group and the latericumbent position group,respectively,the position time was (13.6 ± 2.3)minutes and (6.4 ± 1.6) minutes,the incision length was (7.8 ± 1.9) cm and (6.5 ± 1.4) cm,the operation time was (51.3 ± 4.1) minutes and (45.5 ± 5.5) minutes,the intraoperative blood loss was (99.5 ± 3.5) ml and (82.1 ±3.5) ml (P ＜ 0.05 or 0.01).All patients were healed without complications such as coxa varus,internal fixation loosening or fracture.Conclusion The Asian PFNA-Ⅱ internal fixation in the latericumbent position for senile intertrochanteric fractures has the advantages of simple procedure,less trauma,shorter operation time,and less bleeding,which is worthy of promotion.

Preparation of microspheres of superoxide dismutase and their activities / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To prepare the poly(lactic-co-glycolic acid) (PLGA) microspheres and composite alginate-chitosan-PLGA microspheres containing superoxide dismutase (SOD) and to evaluate their SOD activities.</p><p><b>METHODS</b>The SOD-PLGA microspheres were prepared by W/O/W emulsification method, and the composite microspheres were prepared by two steps:alginate-chitosan microcapsules were first prepared by a modified emulsification and ion crosslinking method, and then they were further dispersed in PLGA to form the composite microspheres. The SOD concentration was determined by Coomassie method, its activity was measured by xanthine oxidase system.</p><p><b>RESULTS</b>The SOD activity was less sensitive to temperature and sensitive to pH, organic solvents, ultrasound and vigorous stir without iced bath. The entrapment efficiencies of SOD in PLGA (50:50) microspheres, PLGA (70:30) microspheres, alginate-chitosan microcapsules, the composite PLGA (50:50) microspheres and the composite PLGA (70:30) microspheres were 36.42%±1.81%, 66.18%±0.05%, 91.08%±1.28%, 87.30%±3.89% and 83.19%±3.48%, respectively. In vitro release tests demonstrated that the SOD activities in 50:50 composite microspheres were higher than that in the PLGA ones at 1 h, 8 h and 1 w.</p><p><b>CONCLUSION</b>The composite alginate-chitosan-PLGA microspheres for SOD sustained release can significantly improve the protein entrapment efficiency and maintain its protein activity.</p>

Analysis of the Epidemic Tendency of Methicillin-Resistant Staphylococcus aureus at a Hospital / 中国康复理论与实践

@#ObjectiveTo analysis the epidemic tendency of the methicillin-resistant Staphylococcus aureus(MRSA).MethodsClinical data of patients from August 2004 to August 2005 were analyzed retrospectively.Results62 Staphylococcus aureus were isolated,and the MRSA isolated rate was 59%.The MRSA patients tended to complex infection.ConclusionThe infection caused by MRSA is serious.It is necessary to take effective measures to control the MRSA prevalence.

Analysis of 52 nosocomial infection cases in neurology rehabilitation department / 中国康复理论与实践

@#ObjectiveTo explore the risk factors causing nosocomial infection (NI) in patients with stroke.MethodsClinical data of 1431 stroke patients discharged from our hospital were analyzed retrospectively.ResultsThe NI incidence rate was 3.63 %. The most common infection sites were respiratory tract, urinary tract and parenchyma. The major pathogens were P. aeruginosa (30%), Stap. Aureus (25%), Acinetobacter baumannii/coalcoaceticus (20%), followed by Streptococcus (10%) and Candida albicans (10%).ConclusionThe main risk factor related to pulmonary NI of cerebral stroke patients is deglutition barrier; the occurrence of infection is also associated with age, invasive procedure and antimicrobial agents.

Analysis of nosocomial infection in patients with spinal cord injury in different seasons / 中国康复理论与实践

@#ObjectiveTo investigate the risk factors of nosocomial infection (NI) of patients with spinal cord injury (SCI).MethodsClinical data of SCI patients hospitalized in our hospital from Jan 1999 to Dec 2004 were analyzed retrospectively.ResultsThe NI rate of SCI patients was 27.78%, and the highest was in summer (33.09%), the lowest was in winter ( 22.41 %). The most common infection sites were urinary tract (71.07%), followed by respiratory tract (14.72%).ConclusionSCI patients are susceptible to NI; prevention and control measures should be taken to decrease the NI rate.

Analysis of nosocomial infection of cerebral palsy children / 中国康复理论与实践

@# ObjectiveTo investigate the influencing factors of nosocomial infection in rehabilitation department of children in our hospital.MethodsThe clinical data including infection part,infection time,immunoglobulin and length of stay of 532 cerebral palsy(CP) children was retrospectively investigated.ResultsSixty-one CP children got nosocomial infection.The nosocomial infection rate was 11.47%,the most common infection sites was respiratory tract(86.89%).March,April and November were the seasons easy to occur nosocomial infection.The levels of immunoglobulin of the infected children were lower than the normal children.ConclusionThe lower level of immunoglobulin,longer hospitalization,ventilation obstructed indoor,and season change maybe the important factors which leading a higher nosocomial infection rate for CP children.

Analysis of nosocomial infection in patients with spinal cord injury / 中国康复理论与实践

@#ObjectiveTo investigate the risk factors of nosocomial infection(NI) of patients with spinal cord injury(SCI),strengthen the prevention and control measures and reduce the NI rate.MethodsClinical data of 967 patients hospitalized in our hospital from Jan 2002 to Dec 2004 were analyzed retrospectively.ResultsThe nosocomial infection rate of SCI patients was 30.3%(293 cases),the most common infection sites were urinary tract,respiratory tract,gastrointestinal tract and wound.The major pathogen was gram-negative bacteria.The infection rate of patients with cervical SCI was significantly higher than patients with thoracic and lumbar SCI(P<0.01).ConclusionSCI patients are susceptible to NI;rehabilitation at early stage should performance to improve living ability of patients and decrease the NI rate.

Antimicrobial resistance of bacteria strains producing extend spectrum β-lactamase in clinic / 中国康复理论与实践

@#ObjectiveTo investigate the resistance character and trend of bacteria strains producing extend spectrum β-lactamase (ESBLs) in clinic.MethodsThe ESBLs-producting K. pneumoniae and E.coli producing ESBLs isolated from Apr 2001 to Mar 2004 in our hospital were screened and confirmed according to NCCLs method.ResultsK. pneumoniae and E.coli with the ESBLs phenotype were increased in recent 3 years with the resistance rate and Gm(MIC) also higher than that not producing ESBLs.ConclusionThe dection of bacteria strains producing ESBLs will be enhanced in order to provide reasonable treatment information.

应用湿性愈合疗法治疗压疮 / 中国康复理论与实践

@#目的探讨应用湿性愈合疗法治疗压疮的疗效。方法将54例压疮患者分为湿性愈合治疗组和传统治疗组,并对两组患者的创面愈合时间、护理工作量、治疗费用进行比较。结果与传统疗法相比,湿性愈合疗法可使压疮的平均愈合时间缩短,换药次数与时间明显减少,而治疗费用接近。结论在有效处理伤口的基础上,湿性愈合疗法更有助于伤口愈合,无需每日换药,不增加患者负担,可替代传统换药方法。