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Objective:To investigate the clinical effect and short-term and long-term effect of total hip replacement (THA) and hemiarthroplasty of hip (HA) in elderly patients with femoral neck fracture (FNF).Methods:59 elderly patients with FNF in South District of Guang′anmen Hospital, Chinese Academy of Traditional Chinese Medicine from March 2017 to January 2019 were retrospectively analyzed. The observation group ( n=29) was treated with THA; The control group ( n=30) was treated with HA. The operation related indexes, short-term and long-term clinical effect (average follow-up of 24.1 months), hip function improvement, pain and complications were compared between the two groups. Short term and long-term clinical effects: the short-term and long-term clinical effects of the two groups were observed by the Harris Hip Score (HHS) of the first month, the third month, the sixth month, the ninth month and the first year after operation. Results:Both THA and HA were effective on elderly FNF, but the effective rate of THA (96.6%) was significantly higher than that of HA (90.0%), with statistically significant difference ( P<0.05); in terms of operation related indicators, compared with the control group, the observation group had longer operation time [ (104.46±3.24)min vs (84.34±3.64)min], more amount of bleeding [(296.64±15.16)ml vs (281.44±12.16)ml], lower postoperative drainage volume [(101.24±4.15)ml vs (74.56±3.24)ml], while the functional recovery of the observation group was better than the control group by HHS ( P<0.05); the postoperative complications and HHS score of observation group were significantly lower than the control group ( P<0.05). Conclusions:THA has the advantages of low complication, fast functional recovery and better effect. The clinical decision should be based on the patient′s physical condition. THA should be used for elderly patients with good basic condition, good surgical tolerance and more daily activities. HA should be used for elderly patients with poor basic condition, low surgical tolerance and less daily activities.
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Objective:To explore characteristics of family function in patients with major depressive disorder (MDD),and to evaluate relationships between family function and prognosis of major depressive episode (MDE).Methods:Forty-six patients with MDD were recruited in the outpatient or inpatient departments of Wuhan Mental Health Center from September 1,2014 to August 31,2015.At the baseline,the patients and their co-resident family members were interviewed for psychiatric screening and diagnosis,and the family function of each patient's family was assessed by Family Assessment Device (FAD).After clinic service or hospitalization,the patients were followed up by telephone until they recovered from the MDE (within 12 months since the follow-up) or for 12 months if they had not achieved remission.Forty-two mentally healthy subjects,with no family members diagnosis for psychiatric diseases,and matched with MDD patients for age,sex,number of children,family roleand socioeconomic status,were recruited from a community.The family function of the MDD families and the controls were compared by independent sample-T test,and the relationship between family function and duration of the MDE was analyzed by Pearson's correlation.Results:MDD families exhibited higher FAD scores in 5 dimensions than control families except for affective involvement and behavior control (P＜0.01).Patients with relatively good family function showed significantly shorter duration of MDE and higher proportion of remission within 6 months since the follow-up (P＜0.01 and P＜0.05).All the dimensions of FAD demonstrated significant positive correlation with the duration of MDE except for the behavior control.Conclusion:Families with MDD patients show impairments in multiple dimensions of family function,and the family functions of MDD patients are correlated with the prognosis of MDE.Improvement of family function may contribute to better prognosis of MDD.
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Objective To determine sexual function in 612 male addicts with methadone maintenance therapy (MMT),analyze its cause and explore the treatment strategies.Methods Self-made questionnaire and International Index of Erectile Function-5 ( IIEF-5 ) were used in 612male addicts receiving MMT.ResultsThe number of addicts who felt worse sexual function was significantly more than those who felt better sexual function (P ＜0.01 ).About 88.6％ addicts were dissatisfied with their current sexual function,90.7％ of whom were willing to continuously receive MMT.The number of addicts suffering from hyposexuality and erectile dysfunction (ED) was significantly increased at post-MMT than at pre-MMT ( P ＜ 0.01 ),while the number of addicts with normal sexuality and inhibitive ejaculation decreased significantly (P ＜0.01 ).Both the dose of methadone and the age of subjects were negatively correlated with IIEF-5 scores.Correlation between the duration of MMT and IIEF-5 scores was not found.ConclusionMMT might deteriorate sexual function in male addicts.To improve the compliance of MMT and sexual function in male addicts,the dose of methadone should be adjusted to minimally effective one.