ABSTRACT
The life safety and quality of life of elderly patients with hip fractures face great threat due to the particularity of fracture site. Elderly patients with hip fracture are often complicated with a variety of basic medical diseases, thus the perioperative management and comprehensive treatment are relatively complex and diverse, and surgical treatment is only one of the links. With the deepening understanding of senile hip fractures, we increasingly realized that the comprehensive management of senile hip fractures should focus on prevention. Combined with the conception and connotation of tertiary-prevention in preventive medicine, this review summarize the common etiology and preventive measures of senile hip fractures, the application of intelligent devices for fall prevention and monitoring, the green channel for hip fracture patient admission, the management mode of the comprehensive geriatric ward based on multi-disciplinary team, the evolution of surgical methods, and the perioperative comprehensive treatments, which in order to provide reference for medical and health workers to reduce the incidence and improve the treatment effects and prognosis of the senile hip fracture via multifaceted and systematic prevention and treatment measures.
ABSTRACT
<p><b>OBJECTIVE</b>To study the factors affecting the long-term prognosis of patients with myasthenia gravis (MG) after thymectomy.</p><p><b>METHODS</b>170 MG patients who had undergone thymectomies were studied retrospectively. Among them, 124 patients received long-term follow-up for more than 40 months postoperatively. The COX regression analysis model was used to analyze the factors that may influence the long-term prognosis. These factors included thymus pathology, patient gender, age, duration of disease at the time of surgery, preoperative Osserman classification and medication.</p><p><b>RESULTS</b>The research showed that thymus pathology was the single independent factor that affected the postoperative long-term prognosis. The long-term survival rates differed significantly with thymus pathological types: hyperplasia > benign thymoma > atrophy > malignant thymoma (P < 0.05).</p><p><b>CONCLUSION</b>The different pathological types of the thymus were the important factor affecting long-term survival in MG patients after thymectomy.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Atrophy , Hyperplasia , Myasthenia Gravis , Mortality , General Surgery , Postoperative Complications , Prognosis , Survival Analysis , Survival Rate , Thymectomy , Thymoma , Thymus Gland , Pathology , General Surgery , Time FactorsABSTRACT
Objective: To study the clinical therapeutic characteristics of myasthenia gravis (MG) with hyperthyroidism and the effects of surgical procedures for the patients. Methods:Subtotal thyroidectomy,thymectomy,and simultaneous subtotal thyroidectomy and thymectomywere performed on eleven patients with MG and hyperthyroidism. These patients were followedup after the operation. Results :The neck incisions were infected in two of seven type Ⅱ b patientsdue to trachestomy and the infected incisions were surgically healed. The MG symptoms of threecases (1 cases in type Ⅱ. and 2 cases in type Ⅱ b) relapsed in 3 to 6 months after subtotal thy-roidectomy. The MG symptoms of 2 cases (1 case in type Ⅱa and 1 case in type Ⅱ b) relapsed in 8to 12 months after thymectomy. Among six patients treated by simultaneous subtotal thyroidecto-my and thymectomy,the MG symptoms relapsed in a type I case 3 months after the operation,remitted in three case (1 case in type Ⅱ, and 2 cases in type Ⅱb) and improved in two type Ⅱ bcases since the operations. Conclusion:The simultaneous subtotal thymectomy and thyroidectomyfor patients with MG and hyperthyroidism might have better effects,although infective opportuni-ty of the neck incisions increased owing to trachestomy. However,the prognostic effects were notvery satisfactory whether simple subtotal thyroidectomy or thymectomy for the patients with MGand hyperthyroidism was performed.
ABSTRACT
Objective:To study the causes that resulted in delayed surgery for bronchial ruptures and the results.Methods:The cases with the bronchial ruptures by the delayed surgery last decade were retrospectively reviewed.The causes and unsatisfactory results were analysed.Results:The severe complications usually occurred after the delayed surgery and the results were not as satisfactory as those by early surgery.Conclusion:The bronchial ruptures ought to be operated in the early stage after being wounded.