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Objective:To compare the early efficacy of proximal femoral bionic nail (PFBN) and proximal femoral nail anti-rotation (PFNA) in the treatment of intertrochanteric fracture in the elderly.Methods:A retrospective cohort study was conducted to analyze the clinical data of 45 elderly patients with intertrochanteric fracture treated at First Affiliated Hospital of Henan Polytechnic University from March 2020 to December 2021, including 13 males and 32 females; aged 70-96 years [(78.6±7.3)years]. According to the AO classification, there were 10 patients with type 31-A1, 16 type 31-A2 and 19 type 31-A3. There were 20 patients treated with PFBN (PFBN group) and 25 with PFNA (PFNA group). The operation time, intraoperaive blood loss, bone healing time, and time to full weight-bearing were compared between the two groups. The tip-apex distance, distance from tail of lag screw to lateral side of intramedllary nail, proximal femoral length and femur neck-shaft angle were compared between the two groups at day 1 postoperatively and at the last follow-up, and their amount of changes between the two time points were also measured. Harris hip score was evaluated at 3, 6 months postoperatively and at the last follow-up. Complications were observed as well.Results:All patients were followed up for 6-21 months [(14.7±3.6)months]. There were no significant differences in operation time, intraoperative blood loss and bone healing time between the two groups (all P>0.05). The time to full weight-bearing was significantly earlier in PFBN group [(7.9±1.2)weeks] than that in PFNA group [(9.1±0.9)weeks] ( P<0.05). At day 1 postoperatively and at last follow-up, the tip-apex distance was (23.4±1.7)mm and (23.3±1.6)mm in PFBN group ( P>0.05), and was (24.5±2.1)mm and (24.3±2.3)mm in PFNA group ( P>0.05); the distance from tail of lag screw to lateral side of intramedllary nail was (8.1±1.1)mm and (11.8±0.9)mm in PFBN group ( P<0.01), and was (7.7±1.0)mm and (12.6±1.6)mm in PFNA group ( P<0.01); the proximal femoral length was (91.3±1.6)mm and (88.5±2.6)mm in PFBN group ( P<0.01), and was (91.4±2.0)mm and (87.6±2.0)mm in PFNA group ( P<0.01); the femur neck-shaft angle was (127.2±2.9)°and (125.7±3.0)° in PFBN group ( P>0.05), and was (128.5±3.0)° and (127.2±3.2)° in PFNA group ( P>0.05). There were no significant differences in the above indicators between the two groups at day 1 postoperatively and at the last follow-up (all P>0.05). The amount of changes in the tip-apex distance and femur neck-shaft angle were (-0.2±0.1)mm and (-1.6±0.7)° in PFBN group, similar with (-0.2±0.2)mm and (-1.5±1.0)° in PFNA group (all P>0.05). However, the amount of changes in the distance from tail of lag screw to lateral side of intramedllary nail and proximal femoral length were (3.6±1.4)mm and (2.7±1.2)mm in PFBN group, significantly lower than (5.2±1.1)mm and (4.0±1.1)mm in PFNA group (all P<0.01). There were no significant differences in Harris hip score between the two groups at 3, 6 months postoperatively or at the last follow-up (all P>0.05). PFBN group had 1 patient with fracture displacement, 2 with compression screw backup and 2 with thigh pain. PFNA group had 1 patient with fracture displacement and 4 with thigh pain. Conclusion:For elderly patients with intertrochanteric fracture, PFBN provides not only earlier full weight-bearing, but also stronger stability of fracture fixation than PFNA.
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Objective To investigate the efficacy of pharmacist intervention in perioperative prophylactic application of antibiotics.Methods From August 2017 to August 2018,148 cases received surgery in Zhejiang Rongjun Hospital were selected ,using odd －even grouping method,the patients were divided into two groups ,with 74 cases in each group.The control group used antibacterial drugs without pharmacists intervention ,the observation group used antibacterial drugs through pharmacists intervention.The use of antimicrobial agents was compared between the two groups.Results The duration of prophylactic medication ,the duration of hospitalization in the observation group were (2.59 ±0.24)d,(8.47 ±0.83)d,respectively,which in the control group were (3.76 ±0.36)d,(10.74 ± 1.32)d,respectively,the differences between the two groups were statistically significant (t＝23.262,12.523,all P＜0.01 ).The total cost of antibacterial drugs and the total drug cost in the observation group were (778.62 ± 76.35)CNY,(3 036.75 ±302.11)CNY,respectively,which in the control group were (1 063.26 ±105.32) CNY, (4 698.64 ±1 452.28) CNY,respectively,and the differences between the two groups were statistically significant (t＝18.823,9.638,all P ＜0.01).The antibacterial drug use satisfaction of the observation group was 97.30%(72／74),which of the control group was 74.32%(55／74),the difference between the two groups was statistically significant(χ2 ＝16.038,P＜0.01).Conclusion The rational use of antibiotics can be promoted by pharmacist intervention in perioperative prophylaxis patients.
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Objective To compare the clinical efficacy of different surgical methods in the treatment of cholecystolithiasis combined with choledocholithiasis,and its effect on immune function. Methods From December 2009 to February 2017,93 patients with cholecystolithiasis combined with choledocholithiasis in Rongjun Hospital and the First Hospital of Jiaxing,were divided into the observation group and the control group according to random number table method. The observation group(47 cases) was given laparoscope combined surgery,and the control group(46 cases) was given conventional laparotomy surgery. The immune function,pain condition,complete stone clearance rate and analgesics use rate of the two groups were compared. Results After treatment,the CD +4 / CD +8 , CD +4 ,CD +8 ,CD +3 in the observation group were (1. 39 ± 0. 36),(40. 12 ± 8. 70)％ ,(22. 62 ± 2. 22)％ ,(56. 77 ± 3. 47)％ ,respectively,which were significantly lower than those in the control group[(1. 70 ± 0. 40),(46. 00 ± 9. 00)％ ,(25. 00 ± 2. 11)％ ,(60. 00 ± 4. 40)％ ],and the differences were statistically significant (t = 3. 93,3. 20, 5. 30,3. 93,all P < 0. 05). The use rate of analgesics in the observation group (4. 26％ ) was significantly lower than that in the control group (21. 74％ ) (χ2 = 6. 32,P < 0. 05). The complete stone clearance rate of the observation group(95. 74％ ) was significantly higher than that of the control group (80. 43％ ) (χ2 = 5. 22,P < 0. 05). After treatment for 3d,7d,14d,the VAS scores of the observation group were (3. 60 ± 1. 20)points,(2. 57 ± 1. 60)points, (0. 60 ± 0. 06) points, respectively, which were significantly lower than those of the control group [(5. 20 ± 2. 22)points,(4. 12 ±2. 30)points,(2. 77 ±1. 30)points],and the differences were statistically significant (t = 4. 31, 3. 77,11. 31,all P < 0. 05). Conclusion For the patients with cholecystolithiasis combined with choledocholithiasis, laparoscope combined surgery has better clinical efficacy,it can significantly improve the patients' immune function and reduce pain.
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Objective@#To investigate the efficacy of pharmacist intervention in perioperative prophylactic application of antibiotics.@*Methods@#From August 2017 to August 2018, 148 cases received surgery in Zhejiang Rongjun Hospital were selected, using odd-even grouping method, the patients were divided into two groups, with 74 cases in each group.The control group used antibacterial drugs without pharmacists intervention, the observation group used antibacterial drugs through pharmacists intervention.The use of antimicrobial agents was compared between the two groups.@*Results@#The duration of prophylactic medication, the duration of hospitalization in the observation group were (2.59±0.24)d, (8.47±0.83)d, respectively, which in the control group were (3.76±0.36)d, (10.74±1.32)d, respectively, the differences between the two groups were statistically significant(t=23.262, 12.523, all P<0.01). The total cost of antibacterial drugs and the total drug cost in the observation group were (778.62±76.35)CNY, (3 036.75±302.11)CNY, respectively, which in the control group were (1 063.26±105.32)CNY, (4 698.64±1 452.28)CNY, respectively, and the differences between the two groups were statistically significant(t=18.823, 9.638, all P<0.01). The antibacterial drug use satisfaction of the observation group was 97.30%(72/74), which of the control group was 74.32%(55/74), the difference between the two groups was statistically significant(χ2=16.038, P<0.01).@*Conclusion@#The rational use of antibiotics can be promoted by pharmacist intervention in perioperative prophylaxis patients.