ABSTRACT
Objective:To investigate the efficacy of internal fixation with common intramedullary nail versus bone cement reinforced antirotation intramedullary nail in the treatment of femoral intertrochanteric fracture. Methods:A total of 106 patients with femoral trochanteric fractures who were surgically treated in Weihaiwei People's Hospital from January 2018 to January 2019 were selected and divided into a control group and an observation group with 53 patients in each group. The control group received internal fixation with common intramedullary nails. The observation group was fixed with bone cement reinforced anti-rotation intramedullary nails. The therapeutic effects were compared between the two groups.Results:There were no significant differences in the amount of blood loss, postoperative Visual Analogue Scale score, amount of fluid drainage, postoperative time to get out of bed, and postoperative hospital stay between the two groups ( t = 1.33, 0.19, 0.34, 0.58, 0.37, all P > 0.05). Operative time in the observation group was significantly longer than that in the control group [(80.21 ± 6.52) minutes vs. (75.92 ± 8.15) minutes, t = 2.99, P < 0.05]. Time to fracture healing in the observation group was significantly shorter than that in the control group [(9.25 ± 1.12) weeks vs. (10.05 ± 1.31) weeks, t = 3.37, P < 0.05]. The incidence of complications in the observation group was significantly lower than that in the control group [3.77% (2/53) vs. 16.98% (9/53), χ2 = 4.97, P = 0.025]. At 6 and 12 months after surgery, Harris hip scores in the observation group were (82.84 ± 6.58) points and (85.55 ± 7.91) points, respectively, which were significantly higher than (78.35 ± 7.54) points and (79.92 ± 9.94) points in the control group ( t = 3.26, 3.22, both P < 0.05). Conclusion:Internal fixation with bone cement-reinforced anti-rotation intramedullary nails for treatment of femoral trochanteric fractures can shorten the time to fracture healing, reduce complications, and improve hip joint function.
ABSTRACT
Objective To evaluate the effects of sevoflurane postconditioning on the oncosis and apoptosis in cardiomyocytes during ischemia-reperfusion (I/R) in isolated rat hearts and the role of extracellular signalregulated protein kinase 1/2 (ERK1/2) signal transduction pathway in it.Methods Seventy-two isolated rat hearts perfused in a Langendorff apparatus were randomly divided into 6 groups (n =12 each) using a random number table:sham operation group (group S),myocardial I/R group (group I/R),sevoflurane postconditioning group (group SP),PD98059 vehicle dimethyl sulfoxide (DMSO) group (group DMSO),selective ERK1/2 inhibitor PD98059 group (group PD),and sevoflurane postconditioning + PD98059 group (group SP + PD).The hearts were subjected to ischemia for 30 min followed by 2 h reperfusion in the other groups except group S.In SP,DMSO and PD groups,the hearts were perfused with K-H solution saturated with 3.0％ sevoflurane,DMSO (＜0.2％) and PD98059 (20 μmol/L),respectively,for 15 min starting from the end of ischemia until 15 min of reperfusion,and then with plain K-H solution for 105 min.In group SP+ PD,the hearts were perfused with K-H solution saturated with 3.0％ sevoflurane and PD98059 for 15 min starting from the end of ischemia until 15 min of reperfusion.Myocardial infarct size and expression of porimin and caspase-8 proteins (by Western blot) were measured at the end of reperfusion.Results Compared with S group,the myocardial infarct size was significantly increased,and the expression of porimin and caspase-8 proteins was up-regulated in the other groups (P ＜ 0.05).Compared with I/R group,the myocardial infarct size was significantly decreased,and the expression of porimin and caspase-8 proteins was down-regulated in group SP (P ＜ 0.05),and no significant changes were found in the other groups (P ＞ 0.05).Conclusion Sevoflurane postconditioning can activate ERK1/2 signal transduction pathway and inhibit the oncosis and apoptosis in cardiomyocytes,thus attenuating I/R injury in isolated rat hearts.
ABSTRACT
A consensus remains unsettled yet for basic medical insurance and common protocols on managing patients seeing doctors out of their hometown.This results in such setbacks as difficulty in seeing doctors elsewhere for those covered and in unaffordable financial burden,as well as medical insurance fraud,lack of information sharing among social insurance authorities,and difficulty of supervision.This study described the status quo of seeding doctors elsewhere under China's basic medical insurance system,and analyzed problems found in the management framework.On such basis,authors proposed such recommendations as unified management system for seeding doctors elsewhere,network information sharing for medical insurance information,and networked settlement for medical expenses for basic medical insurance.These measures should be carried out as per general requirements for health reform stage by stage.
ABSTRACT
0.05),but the level of P- selectin in treatment group were obviously decreased compared with control group after the seventh and fourteenth day(P