Meta-analysis of short-term efficacy between femoral neck system and cannulated compression screw for femoral neck fracture in young and middle-aged patients / 中华骨科杂志

Objective:To investigate the short-term efficacy difference between femoral neck system and cannulated compression screw in the treatment of femoral neck fracture in young and middle-aged patients.Methods:Cochrane Library, PubMed, Web of Science, Embase, CNKI, Wanfang, VIP and CBM databases were searched. All literature on the treatment of femoral neck fractures using the femoral neck system (FNS) or cannulated compression screw (CCS). RevMan 5.4.1 software was used to analyze data.Results:Twelve high-quality cohort studies were included, including 787 patients treated surgically for femoral neck fractures, of whom 369 were treated with FNS and 418 with CCS. Results of meta-analysis showed that FNS had shorter operative time than CCS for femoral neck fracture [ WMD=-8.09, 95% CI (-14.12, -2.06), P=0.009]. FNS had less intraoperative blood loss [ WMD=6.63, 95% CI (1.42, 11.83), P=0.010], Partial weight-bearing time of FNS was earlier postoperative [ WMD=-2.11, 95% CI (-3.00, -1.22), P<0.001], while full weight-bearing time was also earlier postoperative [ WMD=1.01, 95% CI (1.59, 0.43), P<0.001), The postoperative fracture healing time of FNS was shorter [ SMD=0.67, 95% CI (1.04, 0.30), P<0.001]. The Harris score of FNS at the last follow-up was higher [ WMD=4.67, 95% CI (3.26, 6.08), P<0.001]. The number of fluoroscopy during FNS was less [ WMD=-9.05, 95% CI (-10.92, -7.18), P<0.001]. The rate of severe femoral neck shortening after FNS was lower [ RR=0.36, 95% CI (0.19, 0.70), P=0.002]. The incidence of postoperative complications after FNS, including urinary tract infection, venous thromboembolism, bone nonunion, screw loosening, femoral head avascular necrosis, was lower [ RR=0.38, 95% CI (0.27, 0.53), P<0.001]. There was no difference in postoperative hospital stay between FNS and CCS [ WMD=0.01, 95% CI (-0.36, 0.39), P=0.950]. There was no difference in fracture reduction quality (Garden I) [ RR=1.04, 95% CI (0.87, 1.24), P=0.660]. There was no difference in fracture reduction quality (Garden II) [ RR=0.91, 95% CI (0.59, 1.39), P=0.650]. There was no difference in postoperative moderate femoral neck shortening [ RR=0.85, 95% CI (0.58, 1.26), P=0.430]. Conclusion:Compared with cannulated compression screw, femoral neck system had shorter operation time, less intraoperative blood loss, earlier postoperative part load or full load time, shorter fracture healing time higher Harris score at the last follow-up, less number of intraoperative fluoroscopy, and lower rate of severe femoral neck shortening. Besides, FNS had a lower incidence of postoperative complications including urinary tract infection, venous thromboembolism, bone nonunion, screw loosening, and avascular necrosis of femoral head than CCS.

Practice of "ideological and political education" in online nursing teaching under the COVID-19 epidemic / 中华医学教育探索杂志

Jishou University School of Medicine has actively explored the application and effect of online teaching of "ideological and political education" in nursing courses under the COVID-19 epidemic. Taking 135 undergraduates majoring in nursing in batch 2017 as research objects, this study introduces the implementation scheme of online teaching of "ideological and political education". The results show that the online teaching of "ideological and political education" can help nursing undergraduates to establish the professional identity and cultivate medical ethics during the epidemic, to enhance the awareness of the prevention and control of the epidemic, to strengthen the understanding of relevant nursing professional knowledge, and improve students' learning attitude, worthy of reference and promotion.

Observation on the effect of patient -controlled epidural analgesia for the postoperative pain and influence for cytokines of caesarean section / 中国基层医药

Objective To observe the effect of patient -controlled epidural analgesia for the postoperative pain and influence for the cytokines of delivery women with caesarean section.Methods 80 delivery women with caesarean section were selected as research objects,and they were divided into the control group(pethidine by intra-muscular injection group)of 40 cases and the observation group(patient -controlled epidural analgesia group)of 40 cases according to the random number table.Then the pain score,serum pain indexes and cytokines of the two groups before the delivery and at 24h and 48h after the delivery were analyzed and compared.Results The mild pain rates of the observation group at 12h,24h and 48h after the delivery were respectively 75.00%,80.00% and 87.50%,which were all higher than those of the control group(χ2 =6.542,732,6.141,all P <0.05),the serum pain indexes and cytokines were all lower than those of the control group too,the differences were statistically significant (all P <0.05).Conclusion The influence of patient -controlled epidural analgesia for the postoperative pain tress indexes and cytokines of delivery women with caesarean section are great,and it can effectively improve the discomfortableness and inflammatory state of delivery women after the the delivery.

Injectable tissue-engineered bone in treating periarticular bone fracture nonunion under arthroscopy / 局解手术学杂志

Objective To observe the effect of injectable tissue-engineered bone in treating periarticular bone fracture nonunion under arthroscopy. Methods Selected 6 patients with intra-articular bone fracture nonunion:3 cases of humerus intercondylar fracture;2 cases of femoral condylar fracture and 1 cases of tibial plateau fracture. All of the 6 patients have undergone arthroscopic debridment and tissue-engi-neered bone injection in the the fracture ends with puncture needle under direct vision. Percutaneous needle internal fixation were performed if necessary. All the patients have got regular follow-up after the operation process. Check their healing condition with X-ray examination, and the healing of the bone and its complications have also been monitored. Reexamination were made 3, 6, 9, and 12 months after surgery. Results All the patients have experienced successful operation and all the fracture have healed up. The X-ray review showed that the callus healing time was (8. 34 ± 2. 4) weeks and fracture healing time was (18. 2 ± 3. 3) weeks. Accordong to Johner-Wruhs functional category, there were 5 cases of excellent recovery and 1 case of medium recovery. Among these patients, inflammatory reaction occurred in 1 case, and the symptoms disappeared after 2 weeks of Vancomycin anti-inflammatory treatment; deep venous thrombosis occurred in 1 case, and the symptoms disappeared after systematic anticoagulant therapy. Conclusion It’ s safe and effective to treat periarticular bone fracture nonunion with injectable tissue-engineered bone under arthroscopy.

Clinical observation on short-term effects of primary total knee arthroplasty / 局解手术学杂志

Objective To evaluate the short-term effects of total knee arthroplasty ( TKA) , and to detect the causes and prevention of major complications. Methods It was a retrospective study since January 2010 to December 2013. There were 63 patients with 70 knees re-ceived primary TKA. KSS knee scores, HSS knee scores, and range of motion ( ROM) before the operation and during the follow-up were as-sessed and analysed. Results According to the results of follow-up and the X-ray observation, the anteroposterior radiographs showed that the artificial prosthesis were placed well and the joint gap were balanced;the lateral radiographs showed that the artificial joint prosthesis we-rer of appropriate size, good tilt angle, and good package effect. There were two cases developed peroneal nerve palsy and they gradually re-stored in 4 to 6 months after surgery. 5 cases were of poor postoperative ROM (0~60 ± 10)°. Strong analgesic medication-assisted release were conducted in 2 to 3 weeks after surgery. 1 case had patellar pain and resorted by arthroscopic lateral ligament of patellar releasing sur-gery. During the follow-up period, TKA significantly improved HSS and KSS scores compared to preoperative scores. ROM was increased from (78. 3 ± 18. 6)° preoperatively to (109. 2 ± 19. 9)° postoperative (P<0. 01). Conclusion TKA was effective to release knee pain, improve ROM and reduce the incidence of postoperative complications.

The association between tumor necrosis factor receptor 2 gene polymorphism and development of coronary artery disease / 中华检验医学杂志

Objective To study the association of biallelic polymorphism at position 196 in exon 6 of tumor necrosis factor receptor 2(TNFR2) gene and coronary artery disease(CAD).Methods A retrospective case control study was designed in this investigation.Patients with angiographically proven CAD (n=142)and coronary atherosclerosis(n=215)were compared to healthy volunteers(n=631). Genotyping was performed by ShineRoar probes analysis.Results People with GG genotype at position 196 in exon 6 of TNFR2 gene have more risks of development of CAD(OR=2.556,95% CI:1.051～6.218, χ2=4.57,P=0.033)and CA(OR=2.547,95% CI:1.162～5.579,χ2=5.81,P=0.016) than those with TT genotype.Further analysis after adjustment for sex and age demonstrated that GG genotype was not associated with CAD(OR=0.614,95% CI:0.166～2.279,χ2=0.53,P=0.466)and coronary atherosclerosis(OR=O.644,95%CI:0.200-2.069,χ2=0.55,P=0.459).Conclusion Tumor necrosis factor receptor 2 gene polymorphism at position 196 in exon 6 was not an independent risk factor of development of CAD and coronary atherosclerosis among Han Chinese.

Advances in vascularization of tissue-engineered graft / 中华创伤骨科杂志

Vascularization is one of the major c hallenges in tissue engineering gra ft.Vascular plexus falls into two modes which are different in recourse of endotheliocyte:vascul ogenesis and angiogenesis.Both mod es are a dynamic and complicated physiological process.Various kinds of growth factor and adhesion molecule modula te the process.Both in vitro and in vivo methods are used in vascularization research.In vitro methods are used to e-valuate biomaterials for endothelial cell attachment,cytotoxicity,g rowth,angiogenesis and its effects on gene reg-ulation.Chorioallantoic membrane(CAM)is one of the simplest and effective models in vivo.Animals are used as more advanced models.The strategie s of vascularization of tissue engin eering include:modification of the surface of the biomaterials,addition of slow-release growth factor to scaffold,e ndotheliocyte cocultured with other seed cells,wrapping by vascular net,implantin g blood vessel bundles into the graft,seeding biomaterial implants with vascular remnants as vascular template,and c reating perfused microvessels in vitro.None of these approaches,however,is satisfactory at present.We believe that an ideal method will be finally f ound for vascularization in tissue e ngineering with advancement of research on mech anism of vascularization and progre ss in techniques.[

Hygienic Investigation on Indoor Air Quality of Hotels Newly Openned for Business / 环境与健康杂志

ve To understand the indoor air quality of hotels after the openning for business and its health impacts on employees. Methods The hygienic investigation on indoor air quality was carried out in 4 newly built and decorated 2~4-star-grade hotels during the 1st week to the 4th week after openning for businesses well as the health impacts on employees. Results The levels of room temperature, relative humidity, carbon monoxide, carbon dioxide and total count of bacteria in indoor air of hotels showed no significant differences, but the concentrations of formaldehyde(HCHO) and inhalable paniculate (IP) of hotels showed significant differences compared with those of outdoor control(P