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Objective:To investigate the effects of combined spinal-epidural anesthesia (CSEA) on postoperative pain and short-term cognitive function in elderly patients undergoing hip fracture surgery.Methods:A total of 60 elderly patients undergoing hip fracture surgery in Dongchangfu District of Liaocheng People′s Hospital from October 2018 to September 2020 were selected as subjects and they were divided into the control group and the observation group by performed different anaesthesias methods, with 30 patients in each group. The control group underwent total intravenous anesthesia (TIVA), and the observation group underwent CSEA. The scores of visual analogue scale (VAS) at different points and the analgesic recovery rate within 48 h of the two groups were compared, and mini mental state evaluation (MMSE) scores of two groups at different points were evaluated. The levels of serum interleukin (IL)-6, IL-10 and tumor necrosis factor-α (TNF-α) of the two groups before the surgery and on the 1 d after the surgery were compared, and adverse events after the surgery were observed.Results:The analgesic recovery rate within 48 h in the observation group was lower than that in the control group: 3.33%(1/30) vs. 26.67%(8/30), the difference was statistically significant ( χ2 = 6.40, P<0.05). The VAS scores at 4, 6, 12, 24, 48 h after the surgery in the observation group were lower than those in the control group ( P<0.05). The scores of MMSE at 1 and 3 d after the surgery in the observation group were higher than those in the control group: (25.38 ± 2.86) scores vs. (22.17 ± 2.72) scores, (26.89 ± 3.04) scores vs. (25.17 ± 2.69) scores, the differences were statistically significant ( P<0.05). At 1 d after the surgery, the levels of IL-6, TNF-α in the observation group were lower than those in the control group: (67.59 ± 15.47) ng/L vs. (86.75 ± 17.88) ng/L, (18.75 ± 4.23) ng/L vs. (22.81 ± 4.30) ng/L; and the level of IL-10 was higher than that in the control group: (39.78 ± 8.31) ng/L vs. (34.76 ± 7.54) ng/L, the differences were statistically significant ( P<0.05). There was no statistical difference in the total incidence of postoperative adverse events between the two groups ( P>0.05). Conclusions:CSEA can effectively relieve postoperative pain, improve short-term cognitive function, reduce inflammatory response in elderly patients with hip fracture surgery, and with great safety.
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Aspirin is a non-steroidal anti -inflammatory drug,has good antipyretic and analgesic effects , but also inhibits platelet aggregation and antithrombotic effects ,commonly used in clinical coronary heart disease and cerebrovascular disease in first grade , two grade prevention .The need to pay attention to the medication time , interaction,the risk of bleeding ,medication use in special populations in the process ,to ensure the reasonable clinical medication of aspirin .This review summarizes the research progress of aspirin prophylaxis .
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Objective To explore the clinical results and complications of the traditional skeletal traction through olecranon on treating the irreducible humeral supracondylar fracture in children with of ulna.Methods Ninety-eight children patients of humeral supracondylar fracture with failure of reduction manipulation were selected as our subjects.The towel clamp-skeletal traction through olecranon of ulna was applied as the additional treatment methods.Meanwhile 5-24 months' follow-up were performed.Results According to Flynn elbow joint function evaluation standard.The curative effect was as followed.71 patients (74.7％) got the excellent outcome,17 patients (17.9％) for good outcome and 7 patients for improved utcome(7.3％).Therefore,the ratio of excellent operation reached to 92.6％.Conclusion The towel clampskeletal traction through olecranon of ulna might be an effective method to treat reliable fixation regarding of its high curing rate and simple process of performance.
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Objective To study the clinical application value of advanced breast cancer which resistence CAF regimen,treated with semimonthly regimen for paclitaxel combined with 5-fluorouracil/leucovorin 48-hour continuouse infusion.Methods 80 paients with CAF-regimen-resistant ABC were treated with paclitaxel combined with 5-fluorouracil/leucovorin continuouse infusion,paclitaxel 95mg/m2,d_1,LV 200mg,d_1,5-fluorouracil 3g/m2,continuouse infusion for 48 hours with infusion pump.every cycle lasted 2 weeks,at least 4 cycles.Results Of 80 patients,there were 9 complete and 26 partial responses,32 cases remained stable and 13 progressive.The overall response rate of 43.8%.The median time to progression was 8 months.The median survival time was 16.7 months,the patients with soft tissue,lung,pleura,bone,liver obtained response rat was 46.7%(21/45),38.5%(5/13),31.3%(5/16),40%(4/10),20%(2/10).Conclusions semimonthly regimen for paclitaxel combined with 5-fluorouracil/leucovorin 48-hour continuouse infusion is effective and acceptable toxicity,it could be considered as one of the standard chemotherapy for advanced breast cancer which resistence CAF regimen.