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BACKGROUND:Proximal femoral nail antirotation and femoral head replacement could quickly recover hip function in intertrochanteric fractures in the elderly, but whose efficacy is better remains controversial. OBJECTIVE:To compare the differences in the effects of proximal femoral nail antirotation and femoral head replacement on intertrochanteric fractures in the elderly by using a meta-analysis. METHODS:The relevant literatures were searched in PubMed, Cochrane, CNKI, Wanfang database and VIP, and other relevant journal such asChinese Journal of Orthopaedicsand Orthopedic Journal of Chinafor articles published in recent five years. Randomized controled trials concerning proximal femoral nail antirotation and femoral head replacement for the treatment of intertrochanteric fractures in the Chinese elderly were colected. Baseline data, operation time, intraoperative blood loss, postoperative out-of-bed time, length of stay, Harris score, complication rate and number of death were colected and processed using RevMan 5.30 software for meta analysis. RESULTS AND CONCLUSION:Totaly 37 clinical controled trials with 3 216 patients were recruited. Meta-analysis results showed that compared with femoral head replacement, proximal femoral nail antirotation was at a disadvantage in postoperative out-of-bed time, length of stay and joint function in the early stage. No significant difference in complication and mortality was detected between proximal femoral nail antirotation and femoral head replacement. However, proximal femoral nail antirotation had some advantages such as short operation time, smal trauma, and less intraoperative blood loss, and showed good midterm and long-term outcomes of joint function.
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ObjectiveTo investigate the preventive strategy of early post-operative complications of closed spinal dysraphisms in children.MethodsOne hundred and nine children with closed spinal dysraphisms underwent surgery from January 2004 to December 2008,were enrolled in this study.After dural closure,the wound was washed completely with saline to clear the tissue debris to prevent postoperative infection. We routinely made a horizontal incision to prevent postoperative infection. Results After operation,all patients were recovered and were discharged from hospitalNo post-operative complications,including cerebrospinal fluid leakage, wound infection and flap necrosis, were encountered. ConclusionThe sophisticated microsurgical technique and the delicate surgical manipulation is the prerequisite for the prevention of early operational complication of closed spinal dysraphisms in children.
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Lots of problems has exposed in medical system,especially in unreasonable utilization of health resources.This article,from the viewpoint of utilization of health resource,analyzes current problems and countermeasures of the reasonable utilization of health resources.
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To analyze and discuss ethics of treatment in Heinophilic arhtropathy. Treatment of those patients not only could relieve their distress in thought, but also could improve their quality of life. And we raise operational contraindications are relative,not absolute.