ABSTRACT
Clavicle fractures are one of the most common fractures and usually occur in the medial third of the clavicle. The study explored the efficacy of three internal fixation methods to treat Edinburgh IB fractures of the proximal clavicle. 68 patients with Edinburgh IB fractures of the proximal clavicle were divided into T-shaped plate group, double-miniature steel plate group and memory alloy embracing device group. Postoperative complications, return time to work, and fracture healing time were recorded. The clinical efficacy was evaluated by Constant-Murley score of shoulder joint, Visual Analogue Scale (VAS) score of pain, and arm-shoulder-hand dysfunction score. The operative time of the memory alloy embracing device group was significantly better than T-shaped plate group and double-miniature steel plate group. The length of surgical incision in the double-miniature steel plate group was significantly shorter than that in the T-shaped plate group and the memory alloy embracing device group. The hospitalization cost and recovery time of the double-plate and memory alloy hug groups were lower than those of the T-plate group. The double-miniature steel plate group and the memory alloy embracing device group were significantly better than the T-shaped plate group at two weeks after operation. Satisfactory clinical results can be obtained by using T-shaped plate, double-miniature steel plate and memory alloy embracing device in the treatment of Edinburgh IB fracture of proximal clavicle. However, the double-miniature steel plate group has the advantages of small incision, low cost, and quick postoperative recovery, and has more early advantages.
ABSTRACT
The article was designed to explore the clinical efficacy of 'Fast-track Management' guided by ERAS concept under the multidisciplinary collaboration model for early operation of femoral intertrochanteric fracture in the elderly. The clinical data of 198 intertrochanteric fracture in the elderly were retrospectively analyzed. According to the diagnosis and treatment mode, they were divided into cooperative group and routine group. The preoperative waiting time, preoperative deep venous thrombosis, operation time, intraoperative bleeding, hospitalization time, Harris score, VAS score, intervention effect of eras concept, complication occurrence, and 1-year mortality were made a comparison. There were notable differences in the preoperative waiting time, the number of cases of preoperative deep vein thrombosis and the length of hospital stay between the cooperative group and routine group. The incidence of complications in the cooperative group was 9.38%, which was significantly lower than that in the conventional group, 54.90%. The 1-year mortality rate was clearly lower in the cooperative group than in the routine group. At 1 and 2 weeks after operation, VAS, HAMA and PSQI of the cooperative group were lower, but Harris and Barthel were higher than the routine group. At 1 month after operation, there was no clear difference in VAS and Harris between the cooperative group and routine group. The establishment of 'Fast-track Management' based on ERAS concept in the multidisciplinary collaboration model can effectively alleviate the pain of femoral intertrochanteric fracture in the elderly, shorten the hospital stay, reduce the occurrence of postoperative complications and the mortality within 1 year.
ABSTRACT
PURPOSE: To detect the expression and prognostic clinical significance of heat-shock protein gp96 (HSP gp96) in gallbladder cancer. METHODS: Immunohistochemistry was used to detect and compare the rate of HSP gp96 expression in 107 samples of gallbladder cancer, 70 of gallbladder adenoma and 67 of chronic cholecystitis. The association of clinicopathological factors and patients' survival were calculated by univariate and multivariate (Cox proportional hazard regression method) analysis. RESULTS: The expression positive rate of HSP gp96 was 90.7% (97/107) in gallbladder cancer, 71.4% (50/70) in gallbladder adenoma and 47.76% (32/67) in chronic cholecystitis respectively. The positive rate of HSP gp96 in gallbladder cancer tissues was significantly higher than that in gallbladder adenoma and chronic cholecystitis tissues (P < 0.01). Multivariate and Cox regression analysis showed that positive of HSP gp96 (P = 0.026) expression was an independent poor prognostic predictor in gallbladder cancer. CONCLUSIONS: HSP gp96-positive expression is closely correlated with poor survival in gallbladder cancer.
