RESUMO
Objective:To compare the efficacy of metaphyseal expansion and non-expansion when using proximal femoral nail antirotation（PFNA）in the treatment of severe osteoporotic intertrochanteric fracture in the elderly.Methods:A retrospective case-control study was conducted to analyze the clinical data of 66 elderly patients with severe osteoporotic intertrochanteric fracture admitted to Honghui Hospital, Xi'an Jiaotong University from January 2019 to January 2020, including 49 males and 17 females. The age ranged from 75 to 89 years［（80.9±3.3）years］. The AO types of fractures were 31-A1 in 23 patients, 31-A2 in 22 and 31-A3 in 21. A total of 34 patients were stabilized by the PFNA technique with metaphyseal expansion（metaphyseal expansion group）and 32 patients received PFNA fixation without metaphyseal expansion（metaphyseal non-expansion group）. The total blood loss, hidden blood loss, intraoperative blood loss, dominant blood loss, postoperative drainage, transfusion volume, transfusion rate, operation time, hospital stay and fracture healing time were compared between the two groups. The hip functional recovery was assessed by Harris hip score at 1, 3, 6 months postoperatively and at the last follow-up. The incidence of complications was observed.Results:All patients were followed up for 12-17 months［（13.5±1.1）months］. The total blood loss, hidden blood loss, intraoperative blood loss, dominant blood loss, postoperative drainage in metaphyseal expansion group were（976.3±210.1）ml,（712.4±224.4）ml,（139.4±21.0）ml,（263.8±36.3）ml,（124.4±29.5）ml respectively, significantly higher than those in metaphyseal non-expansion group［（799.0±119.5）ml,（603.0±136.4）ml,（94.1±18.8）ml,（195.9±35.4）ml,（101.9±27.5）ml］（ P<0.05）. The transfusion volume［2（0, 2）U］and transfusion rate［53%（18/34）］in metaphyseal expansion group ware increased compared to metaphyseal non-expansion group［0（0, 1.5）U, 25%（8/32）］（ P<0.05）. There were no significant differences in operation time, hospital stay, fracture healing time or hip Harris score at 1, 3, 6 months after surgery and the last follow-up between the two groups（ P>0.05）. No wedge-shaped distraction deformity, fracture nonunion, femoral head necrosis, wound infection, pulmonary embolism or fat embolism occurred in both groups. There was no significant difference in the incidence of iatrogenic lateral wall fracture, lower limb venous thrombosis or postoperative medical complications between the two groups（ P>0.05）. Conclusion:For elderly patients with severe osteoporotic intertrochanteric fracture, both PFNA with metaphyseal expansion and non-expansion can achieve satisfactory results, while the metaphyseal non-expansion is superior in perioperative blood loss and transfusion rate.
RESUMO
Objective To observe the curative effect of oseltamivir combined with Lingjiaowuhutang in children with influenza. Methods One hundred and twenty cases of children with influenza were selected from November 2017 to December 2017 and they were divided into two groups, each with 60 cases. The patients in western medicine group were treated with oseltamivir alone , those in Chinese traditional medicine combined with western medicine group were treated with oseltamivir and Lingjiaowuhutang. The efficacy and duration of fever and cough were was compared between two groups. Results Thirty-three patients were confirmed influenza A and 87 patients were confirmed influenza B. The total effective rate in Chinese traditional medicine combined with western medicine group was significantly higher than that in western medicine group: 96.7% (58/60) vs. 86.7%(52/60), χ2= 3.927, P < 0.05. The duration of fever and cough in Chinese traditional medicine combined with western medicine group was significantly shorter than those in western medicine group: (30.18 ± 6.22) h vs. (36.24 ± 13.46) h, (120.18 ± 21.45) h vs. (143.14 ± 33.26) h, P < 0.05. Conclusions Oseltamivir combined with Lingjiaowuhutang in children with influenza has better efficacy and can shorten duration of disease. It is worthy of clinical application.