Prediction of internal fixation failure of femoral trochanteric fracture by external wall morphology / 中国骨伤

OBJECTIVE@#To investigate the relationship between the shape of the lateral wall and the early failure of internal fixation in the fracture of the femoral trochanteric region(FFT).@*METHODS@#Total 295 patients with femoral trochanteric fracture underwent internal fixation from January 2015 to January 2020 were selected. The patients were divided into two groups according to whether there was early internal fixation failure after surgery, 19 patients in the failure group and 276 patients in the normal group. Gender, affected side, age, AO classification, body mass index(BMI), preoperative hemoglobin, X-ray measurement of lower lateral wall thickness, preoperative internal diseases, intraoperative blood loss, postoperative tip apex distance(TAD), postoperative neck shaft angle, operation time and other data were compared between two groups. The shape of the lateral wall was compared between two groups, and the correlation between the shape of the lateral wall and the early internal fixation failure of femoral trochanteric fracture was analyzed.@*RESULTS@#All patients were followed up for more than 1 year. There was no significant difference between two groups in terms of intraoperative blood loss, operation time, postoperative TAD, and postoperative neck shaft angle(P>0.05). At the latest follow-up, the visual anaglue scale (VAS) of the failure group was higher than that of the normal group(P<0.01), and the Harris score of the failure group was lower than that of normal group(P<0.05). The receiver operator characteristic (ROC) curve between shape of lateral wall and failure of early internal fixation of femoral trochanteric fracture was drawn. The critical value of the midpoint lateral wall thickness was 16.5 mm, and the area under the ROC curve was 0.845;The critical value of average sidewall thickness was 16.5 mm, and the area under ROC curve was 0.838;The critical value of the axial area of the sidewall was 7.5 mm, and the area under the ROC curve was 0.826.@*CONCLUSION@#The shape of the lateral femoral wall measured by CT could be used as a predictive factor for the early failure of internal fixation of femoral trochanteric fractures. For patients at risk, more reasonable surgical plans and postoperative preventive measures should be developed.

Professor LU Fan's clinical experience in shallow needling technique of acupuncture / 中国针灸

Professor LU Fan adheres to the principle in clinical practice, "the needling principle concentrated on regulating qi ". She takes the advantages of shallow needling technique of acupuncture in treatment of various diseases, e.g. exogenous disease, initial onset of disorder, chronic bi disorder, intractable diseases, disorder of yang nature, disorder of heat nature, thin body, pediatric diseases, disorders on the unilateral side of the body and acute diseases. Besides in compliance with classics, she has broadened the application scope of shallow needling technique of acupuncture and improved the clinical therapeutic effect.

Pharmacological effects of volatileoil from Alpinia officinaruim in treating cardiovascular diseases / 中国药理学与毒理学杂志

Galangal (Alpinia officinaruim Hance) is the rhizome of the perennial herb belonging to Zingiberaceae family. There are many active components in galangal, such as volatile oil, flavonoids, terpenoids, phenylpropanoids and glycosides, among which the content of volatile oil is higher. The bioactivities of galangal volatile oil on health effect includesanti-inflammatory, anti-hypertension, anti-oxidation and prevention of cardiovascular diseases. Cardiovascular disease (CVD) is a kind of diseases related to circulatory system, which is also called circulatory system diseases. Over the past decade, the number of people dying from CVD has increased by 12.5％ worldwide, and it is now the leading cause of human death worldwide. Studies have shown that galangal volatile oil has good pharmacological effects in treating CVD. ① Regulation of glucose and lipid metabolism: studies have found that abnormal lipid metabolism can lead to obesity, diabetes, CVD and other diseases. The serum total triglyceride (TG) content in liver and serum will increase in patients with abnormal fat metabolism. The results showed that the volatile oil of galangal could increase the excretion of neutral cholesterol, significantly reduce liver TG and serum TG, and thus regulate glucose and lipid metabo?lism, prevent lipid deposition and prevent CVD. ② Improving insulin resistance (IR): inhibition of inflammatory cytokines such as IL-1, IL-6 activation and expression of TNF-α, improves IR, thereby protecting myocardium from IR-mediated damage. Through the establishment of endothelial cell injury model induced by high glucose in vitro, it was found that the volatile oil of galangal can significantly reduce the secretion of pro-inflammatory cytokines TNF-αand IL-8, and inhib?it the expression of ICAM-1 and VCAM-1 induced by high glucose, suggesting that it has protective effect on endothelial dysfunction and inflammation induced by high glucose.③Regulate blood oxygenation:during acute myocardial hypoxia, the activity of free radical scavenging system is decreased, and oxygen free radicals are produced in large quantity, which reacts with unsaturated fatty acids on the cell membrane and forms lipid peroxidation, resulting in myocardial structural damage. The results showed that the water extract of Galangal could reduce the content of MDA in blood and protect the SOD activity of ischemic and hypoxic myocardium.④ Protective effect of vascular endothelial cells (ES):ES injury is the pathological basis of some cardiovascular diseases. The results showed that the volatile oil of galangal had a protective effect on ES apoptosis. Compared with the morphology and activity of ES treated with oxidized LDL, galan?gal volatile oil could ameliorate these morphological changes and improve cell viability. ⑤ Antiplatelet agglutination:inhibit platelet aggregation and thromboxane release, improve blood circulation, and have obvious anti-thrombotic effect, which has a good effect on the treatment and prevention of cardiovascular diseases. The results showed that the volatile oil of galangal had inhibitory effect on platelet aggregation and anticoagulant effect. In conclusion, the volatile oil of galangal can be used to prevent and treat cardiovascular diseases. Based on the mechanism of CVD, this study summa?rized the role of the essential oil of Alpinia officinaruim in CVD, providing basis for the clinical application of alpiniaoffici?nalis essential oil in the prevention and treatment of CVD and the development of new drugs.

Effect of femoral offset on proximal femoral anti rotation intramedullary nail in the treatment of femoral trochanteric fractures / 中国骨伤

OBJECTIVE@#To investigate the effect of femoral offset (FO) on the postoperative functional results of proximal femoral nail antirotation (PFNA) in femoral trochanteric fractures.@*METHODS@#From May 2017 to June 2019, 112 patients receiving PFNA were analyzed, X-ray and CT examination of both hips were performed before operation, and X-ray examination of both hips of pelvis was performed on the first day after operation. Among them, 71 patients showed bilateral FO difference≤ 5 mm on positive X-ray film (group A), and 41 patients showed bilateral FO difference>5 mm (group B). There was no significant difference between two groups in gender, age, operative side, course of disease, Harris score of preoperative hip joint, preoperativeFO(@*RESULTS@#Patients in both groups were followed up for 12 months after surgery, and all patients reached the healing criteria. The difference of Harris score of the hip joint at 6 and 12 months after surgery was statistically significant (@*CONCLUSION@#In the treatment of trochanteric fractures with PFNA, the greater the difference of FO between the two sides, the worse the postoperative function of the patients. The appropriate FO(the difference of FO between the two sides ≤5 mm) can improve the postoperative function of the patients.

Analysis of risk factors of perioperative blood transfusion in the treatment of femoral intertrochanteric fracture with proximal femoral nail antirotation / 中国骨伤

OBJECTIVE@#To explore the influencing factors of perioperative blood transfusion in the treatment of elderly femoral intertrochanteric fractures with proximal femoral nail antirotation(PFNA).@*METHODS@#The clinical data of 109 elderly patients with intertrochanteric fractures who received PFNA treatment from July 2018 to January 2020 were retrospectively analyzed. Both pelvic hip X-rays and CT plain scans were performed before surgery. All patients were diagnosed by X-ray and CT plain scan of pelvis and hip before operation. Through the statistical analysis of the basic data of patients before and during operation, the risk factors of perioperative blood transfusion were explored.@*RESULTS@#Logistic regression analysis showed that age (@*CONCLUSION@#Age, fracture type, diabetes history, and preoperative hemoglobin are independent risk factors for perioperative blood transfusion in the treatment of elderly intertrochanteric fractures with PFNA. The older the patient, the history of diabetes, the more unstable the fracture, and the lower preoperative hemoglobin, the more likely it is to require a blood transfusion, which may provide a reference for clinical perioperative blood transfusion decisions.