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Objective:To investigate the risk factors of lower extremity venous thrombosis in elderly patients with femoral neck fracture during perioperative period after artificial bipolar femoral head replacement and the effect of Mailuoshutong in clinical prevention and treatment of thrombosis.Methods:A retrospective case-control study was conducted on the clinical data of 92 elderly patients with femoral neck fracture who were admitted to the Affiliated Hospital of North China University of Technology from January 2015 to January 2020.According to the treatment method, the patients were divided into an observation group (44 cases) and a control group (48 cases). Patients in the observation group were treated with the combination of Mailuoshutong Pill and low molecular weight heparin calcium.The control group was treated with low molecular weight heparin calcium.The patients in both groups started anti-coagulation therapy immediately after admission, and they stopped the drug one day before operation and continued to take the drug on the second day after operation.Venous ultrasound of both lower limbs was recorded at the time of admission, on the 7th day after admission, and 14 days after surgery.The changes in hemoglobin, red blood cell count and drainage volume before and after operation were recorded.Results:The incidence of thrombosis was 2 cases (4.54%) on the 7th day after admission in the observation group and 9 cases (18.75%) in the control group.The difference was statistically significant (χ 2=4.400, P=0.036). The incidence of thrombosis was 3 cases (6.82%) in the observation group and 11 cases (22.92%) in the control group 14 days after operation.The difference was statistically significant(χ 2=4.611, P=0.032). The hemoglobin changes of observation group and control group were (23.73±6.89) g/L and (22.10±5.18) g/L respectively on the first day before operation and 48 hours after operation.The red blood cell count changes were (0.67±0.32) × 1012/L and (0.56±0.36) × 1012/L respectively, and the drainage volume of drainage tube after operation was (100.27±23.73) ml and (102.40±20.90) ml, respectively.There was no significant difference in the above indexes between the two groups (all P>0.05). Multivariate Logistic regression analysis showed that only low molecular weight heparin calcium was used to prevent and treat thrombosis ( OR=10.281, 95% CI: 1.609-65.689, P=0.014); the elderly patients ( OR=1.190, 95% CI: 1.061-1.336, P=0.003) and the thrombosis at the time of admission ( OR=8.346, 95% CI: 1.773-39.281, P=0.007) were the risk factors for lower extremity venous thrombosis on the 14th day after surgery. Conclusion:Mailuoshutong pill combined with low molecular weight heparin calcium can safely and effectively treat lower extremity venous thrombosis in perioperative period of artificial femoral head replacement for femoral neck fracture in elderly patients.Mailuoshutong pill combined with low molecular weight heparin calcium was a protective factor for lower extremity venous thrombosis 14 d after operation, while advanced age and thrombosis at the time of admission were risk factors.
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Objective:To study the clinical effect of Maizhiling tablets combined with salmon calcitonin in the treatment of elderly femoral neck fracture after artificial femoral head replacement and the influencing factors of hip joint function 6 months after operation.Methods:Prospective research methods were used in this article.A total of 84 elderly patients with femoral neck fracture who underwent artificial femoral head replacement in the Affiliated Hospital of North China University of Science and Technology from January 2017 to June 2019 were selected and randomly divided into the treatment group (41 cases) and the control group (43 cases) by the random number table method.The treatment group was treated with Maizhiling tablet and salmon calcitonin nasal spray plus basic calcium; the control group was treated with basic calcium.Independent sample t test was used to compare the visual analogue score (VAS) on the 5th day after operation, the time of complete disappearance of congestion in thigh, and the time of first ambulation after operation between the two groups.The bone mineral density (BMD) of contralateral femoral neck and Harris score of hip joint function were compared between the two groups at 14 days, 3 months and 6 months after operation by repeated measurement variance analysis.Multivariate Logistic regression was used to analyze the influencing factors of hip joint function at 6 months after operation.Results:VAS score on the 5th day after surgery: (6.34±1.54) points in the treatment group and (7.02±1.50) points in the control group.Complete regression time of thigh congestion: (12.12±2.27) d in the treatment group and (13.88±2.58) d in the control group.The first postoperative activity time was (5.93±1.52) d in the treatment group and (7.84±1.05) d in the control group, and the differences of the above indexes between the two groups were statistically significant ( t value was 2.051, 3.313, 6.673, respectively, all P<0.05). The BMD values of the contralateral femoral neck in the treatment group were (0.543±0.123), (0.561±0.119), (0.606±0.105) g/cm 2 at 14 days, 3 months and 6 months after operation, and (0.530±0.092), (0.517±0.089), (0.526±0.090) g/cm 2 in the control group.The results of variance analysis of repeated measurements showed that Fintra-group=55.726, P<0.01; Finter-group=4.206, P<0.05; Finteraction=57.654, P<0.01.There were significant differences between 3 months, 6 months and 14 days after operation in the treatment group (all P<0.01), and between 3 months and 6 months after operation ( P<0.01). In the control group, there was significant difference between 14 days and 3 months ( P<0.01), and between 3 months and 6 months ( P<0.01); 6 months after operation, the difference was statistically significant ( P<0.01). The Harris scores of hip joint in the treatment group were (82.12±8.18), (85.49±6.61), (87.10±6.57) points and (78.91±5.75), (81.44±6.42), (83.67±6.97) points in the control group.The results of repeated measurement ANOVA showed that Fintra-group=64.526, P<0.01; Finter-group=6.529, P<0.05; Finteraction=0.501, P>0.05.There were significant differences between 3 months, 6 months and 14 days after operation (all P<0.01). There were significant differences between 3 months and 6 months after operation ( P<0.05). There were significant differences between the groups 14 days, 3 months and 6 months after operation ( P<0.05 or P<0.01). Multivariate logistic regression analysis showed that age( OR=1.318, 95% CI1.002-1.732, P=0.048) and treatment method ( OR=29.168, 95% CI 1.030-824.623, P=0.048) were risk factors for hip function on the replacement side, and Harris score of hip function 14 days after surgery ( OR=0.624, 95% CI 0.447-0.873, P=0.006) were protective factors for hip function 6 months after surgery. Conclusion:Maizhiling tablets and salmon calcitonin nasal spray have good effects on removing blood stasis, relieving pain, effectively improving bone mineral density and promoting the recovery of joint function after artificial femoral head replacement for senile femoral neck fracture.The younger age of patients, postoperative treatment with Maizhiling tablets combined with salmon calcitonin and good recovery of hip function in 14 days after operation are the protective factors of good hip function in 6 months after operation.
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[Objective] To develop a new type nerve tissue engineering scaffolds to repair the defect of peripheral nerve and observe the growth of bone marrow stromal cells cultured in vitro on the scaffolds.[Method]The biomaterial was made of I-collagen and gelatin by freeze-drying method,the alignment regularities of microscopic channels and there course directions were observed under the scanning electronic microscope.The size of the micropores and the factor of porosity were also measured.The bone marrow stromal cells were seeded on the collagen scaffolds and cultured for 5 days,then the growth of bone marrow stromal cells cultured in the scaffolds was observed.[Result]All the scaffolds were circular cylinder,the microscopic channels were arranged in parallel manners,and the pore sizes of the channels were uniform.The bone marrow stromal cells were seeded in the scaffolds successfully.[Conclusion]The developed nerve tissue engineering scaffolds have good structure and biocompatibility,which can be used in the repair of the nerve injuries.
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[Objective]To explore the differentiation of bone marrow stromal cells(BMSCs) induced by OECs conditioned medium.[Method]The purified OECs were acquired by seleclive culture medium and cultivated in the polylysine coated plate.After 9～12 days culture, OECs conditioned medium was obtained by 2000 r/min configuration and then co-cultivated with purified BMSCs which were 3th generation.The differentiation of BMSCs were observed under inverted microscope and were identified by immumofluorescence method.[Result]The OECs conditioned medium had obviously effects on BMSCs' differentiation.BMSCs differentiation into neuron-like cells ratio was 55% and differentiation into astroctes cells ratio was 23%.[Conclusion]The conditioned medium which comes from OECs culture supernatant has obviously effects on BMSCs' differentiation into neuron-like cells.