ABSTRACT
BACKGROUND:There is no unified method for treatment of intertrochanteric fracture. Previous dynamic hip screw fixation has some shortcomings, and is gradual y replaced by intramedul ary nail fixation. interTan is a compression interlocking intramedul ary nail designed by Smith Nephew in USA according the characteristics of intertrochanteric fracture. Unique design of pressurized screw thread has control able linear pressure. Moreover, it has the stability of Z-effect anti-rotation. OBJECTIVE:To analyze the clinical therapeutic effects and superiority of interTan compression interlocking intramedul ary nail for intertrochanteric fracture. METHODS:A total of 60 patients with intertrochanteric fracture undergoing interTan compression interlocking intramedul ary nail in the Department of Orthopedics, Beijing Chaoyang Emergency Rescue Center from January 2011 to December 2012 were enrol ed in the experimental group. A total of 60 patients with intertrochanteric fractures receiving dynamic hip screw fixation in the Department of Orthopedics, Beijing Chaoyang Emergency Rescue Center from January 2009 to December 2010 were enrol ed in the control group. RESULTS AND CONCLUSION:Peri-operative bleeding volume, postoperative ambulation time, numerical rating scale score, radiographic healing time and weight-bearing time in the experimental group were lower than those of control group. At 3, 6 months and 1 year after fixation, Harris score and hospital for special surgery knee score were higher in the experimental group than in the control group. These data indicated that compared with dynamic hip screw, interTan compression interlocking intramedul ary nail has unique stability due to its design. Internal fixation can reduce operation trauma, promote fracture healing and improve joint function, and exhibit good clinical therapeutic effects for intertrochanteric fractures.
ABSTRACT
Objective To observe the changes of carotid intima-media thickness(CIMT) and vascular endothelia function in patients with geriatric carotid plaque before and after intensive lipid lowering was performed.Methods 102 patients diagnosed with carotid plaque were ramdomly divided into common group (atorvastatin 10 mg/d,n=48) and intensive lipid lowering group (atorvastatin 20 mg/d,n=54).After one year of treatment,the fasting venous blood total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),high density lipeprotein cholesterol (HDL-C) and triglyceride (TG) were assayed,and the thickest and thinnest CIMT and brachial arterial.endothelium dependent diastolic function (FMD) and carotid artery plaque index(PI) were measured by ultrasound.Results Two groups in the thickest CIMT and PI had no significant difference before and after treatment (P＞0.05).The levels of FMD,TC,LDL-C,TG and the thinnest CIMT had significant difference before and after therapy [common group:GIMT(0.85±0.20)mm,(0.83±0.22) mm,FMD(3.85±1.41)%,(7.91±1.05)%,TC(6.46±1.05) mmol/L,(4.82±1.26) mmol/L,LDL-C (4.71±1.00) mmol/L,(3.16±1.00) mmol/L,TG (1.55±0.45) mmol/L,(1.49±0.44) mmol/L;intensive lipid lowering group:CIMT(0.84±0.20) mm,(0.63±0.17) mm,FMD (3.74±1.38) %,(0.25±1.58)%,TC (6.36±1.06) mmol/L,(4.10±1.00) mmol/L,LDL-C (4.73±1.01) mmol/L、(2.28±1.26) mmol/L,TG (1.56±0.53) mmol/L,(1.50±0.49) mmol/L,P＜0.05].After one year's therapy,the difference in intensive lipid lowering group was more obvious than in common group (P＜0.05).Conclusions Intensive lipid lowering therapy is more effective to decrease TC,LDL-C and CIMT and to improve the vascular endothelia function.Atorvastatin is effective to stabilize the plaque and to retard the atheroscleresis development.
ABSTRACT
Objective To observe the curative effect of telmisartan on sinus rhythm maintenance in patients with nonvalvular paroxysmal atrial fibrillation (AF) after the recovery of sinus rhythm with amiodarone. Methods Seventy-six patients with nonvalvular paroxysmal atrial fibrillation who visited our hospital were randomly divided into two groups: control group (amiodarone, n=36) and treatment group (telmisartan plus amiodarone, n=40). The maintenance of sinus rhythm and the change of left atrial diameter between the two groups at 3, 6 and 12 months after therapy were observed. Results The left atrial diameter and the maintenance rate of sinus rhythm between the two groups at 3 and 6 months after therapy had no statistically significant difference (t=0.04, 0.51, 0.03, 1.12, all P>0.05). After 1-year treatment, the maintenance rates of sinus rhythm were 48.4% and 73.5% in treatment group and control group ,respectively (t=4.33,P<0.05), and the left atrial diameter was significantly shorter in treatment group than in control group [(34.38±3.85) mm vs. (37.26±4.85)mm ,t=2.66, P<0.05]. Conclusions The combination of telmisartan and amiodarone is more effective than amiodarone alone on maintenance of sinus rhythm in patients with nonvalvular paroxysmal AF after the recovery of AF. The curative effect may be due to telmisartan effects on inhibiting the activation of renin-angiotensin system, decreaseing the cardiac burden and delaying the cardiac remodeling.