Search

目 的 观察全膝关节置换术( TKA) 中截骨后与切皮前应用止血带对患者 围手术期失血及术后恢复情况 的影响 。 方法 选取行初次 TKA 的单侧膝关节骨关节炎患者 92 例，根据术中止血带的应用时机分为截骨后组与 切皮前组各 46 例。 截骨后组在截骨完毕后使用止血带 ， 假体安装后放开止血带 ； 切皮前组在皮肤切开之前使用止 血带，切口缝合完毕后放开止血带 。 记录两组手术时间 、止血带使用时间及失血相关指标（术中出血量、术后引流 量、隐 性失血量、 总失血量） ， 术前及术后 24 h 血红蛋自 ( Hb) 、 红细胞比容(Hct) ， 术前及术后 1 、3 、5 d 膝关节疼痛 视觉模拟评分( VAS) ， 术前及术后 1 周 、1 月 膝关节 HSS 评分。 结果 两组手术时间 比较差异无统计学意义 ( P > 0. 05 ) 。 截骨后组止血带使用时间短于切皮前组 ，术中失血鼠高于切皮前组 ， 术后引 流最、 隐性失血鼠、 总失血最均 低于切皮前组 ( P均< 0. 05 ) 。 两组手术前后 Hb、Hct 比较差异均无统计学意义 ( P 均 ＞ 0. 05 ) 。 截骨后组术后 1 、5 d 膝关节 VAS 均低于切皮前组同时间点 ， 术后 1 周 、1 月 膝关节 HSS 评分均高于切皮前组 同时间点 ( P 均 < 0. 05 ) 。 结论 TKA 术中截骨后使用止血带、安装假体后放开止血带可显著降低患者围手术期总失血量 ，并有助于减轻患 酶 者疼痛、促进术后膝关节功能恢复。 [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical efficacy of joint replacement and internal fixation in the treatment of elderly osteoporosis complicated with femoral intertrochanteric fracture. Methods: A total of 96 elderly patients with osteoporosis complicated with femoral intertrochanteric fracture, who were treated in Guangrao People’s Hospital from December 2011 to December 2014, were randomly divided into control group and experiment group. The control group was treated with internal fixation, while the experiment group, with joint replacement. The clinical efficacy, the incidence of complications and the bone density of two groups were compared.Results: The time of getting off the bed and the incidence of complications of the experiment group were obviously shorter and lower than those of the control group(P<0.05). The optimal and good rate of experimental group(95.83%) was significantly better than that(70.83%) of control group(P<0.05). Bone density of the two groups after treatment were higher than before treatment(P<0.05), and the bone density of experimental group after treatment was higher than that of the control group(P<0.05). Conclusion: Joint replacement has a better clinical efficacy than internal fixation in the treatment of elderly osteoporosis complicated with femoral intertrochanteric fracture,which can significantly reduce the incidence of complications, increase bone density, and improve the prognosis of patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: Medial collateral ligament injury in total knee arthroplasty is a rare but serious complication. There are different opinions on the treatment of medial collateral ligament injury. OBJECTIVE: To analyze the injury site of medial collateral ligament in primary total knee arthroplasty and evaluate the curative effect of local suture repair combined with brace protection and support after injury. METHODS: A retrospective analysis of 14 cases of iatrogenic medial collateral ligament injury during total knee arthroplasty in Department of Joint Surgery, Affiliated Hospital of Qingdao University from January 2016 to January 2018 (trial group) was conducted. All cases were treated with local suture repair combined with brace protection for 6 weeks. 110 cases without injury of medial collateral ligament in the same period were selected as controls (control group). The location of medial collateral ligament injury was recorded and the causes of injury were analyzed. Range of motion and American knee society knee score were compared between the two groups before and after operation. RESULTS AND CONCLUSION: (1) Totally 12 cases of medial collateral ligament injury, including 11 cases of anterior bundle and 1 case of posterior bundle, who experienced transverse injury; and 2 cases of tibial avulsion. (2) Range of motion of the knee joint in the trial group and the control group was significantly improved after operation compared with preoperation (P < 0.05), and there was no significant difference between the two groups in range of motion at 2 months and 1 year after operation (P > 0.05). (3) At the last follow-up, American knee society knee score was significantly higher in the trial and control groups compared with preoperation (P < 0.05); however, there was no significant difference between the two groups (P > 0.05). (4) In the first total knee arthroplasty, the injury of the anterior bundle and body of the medial collateral ligament was the main injury, and the direct repair of the ligament combined with the protection of the post-operative brace for 6 weeks can achieve a good therapeutic effect, without the use of restrictive prosthesis, ligament reconstruction and other complex surgical treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND: Naoxinqing capsule has been used for treating cerebral ischemia/reperfusion injury for a long time. However, there are relatively few in-depth studies on its mechanism. OBJECTIVE: To investigate the therapeutic effect of Naoxinqing Capsule on gerbil model of cerebral ischemia/reperfusion injury by molecular biological means. METHODS: The study was approved by the Laboratory Animal Ethical Committee of Liaoning University of Chinese Medicine, approval No. 21000092017072. Eighty male Mongolian gerbils were randomly divided into sham, model, Naoxinqing and Naoluotong groups, and the latter three groups underwent bilateral common carotid artery clip for 5 minutes, to establish the model of cerebral ischemia/reperfusion injury. The sham group received no common carotid artery clip. Next day, the sham group fed normally, the model group was given normal saline, Naoxinqing group was given the 100 mg/(kg•d) Naoxinqing via gavage, and Naoluotong group given 100 mg/(kg•d) Naoluotong via gavage, respectively, for 21 consecutive days. The water maze test was conducted at 1 week before experiment ended. The brain tissue was removed after experiment. The learning and memory function, hippocampal neurons, cerebrovascular and corresponding molecular changes were detected. RESULTS AND CONCLUSION: (1) Compared with the sham group, the learning ability in the model group was decreased significantly. Naoxinqing and Naoluotong groups could effectively improve the learning ability after surgery. (2) Compared with the model group, the numbers of neurons in the Naoxinqing and Naoluotong groups were increased significantly, arranged regularly with clear contour and complete structure. (3) Compared with the model group, in the Naoxinqing and Naoluotong groups, the activities of superoxide dismutase and lactate dehydrogenase, and glutathione content were significantly increased, and the content of malonaldehyde was significantly decreased (P < 0.01). (4) The expression levels of ASC, NLRP3 and Caspase-1 in the hippocampus in the Naoxinqing and Naoluotong groups were significantly lower than those in the model group (P < 0.05). (5) The levels of interleukin-18 and interleukin-1β in the Naoxinqing and Naoluotong groups were significantly lower than those in the model group (P < 0.01). (6) Compared with the model group, the cells positive for platelet endothelial cell adhesion molecule-1 in the Naoxinqing and Naoluotong groups were significantly increased, the cells contacted closely each other. (7) Compared with the model group, in the Naoxinqing and Naoluotong groups, the expression levels of platelet endothelial cell adhesion molecule-1 and phosphorylated endothelial nitric oxide synthase were significantly up-regulated, and the content of nitric oxide was significantly increased (P < 0.01). (8) These results indicate that Naoxinqing and Naoluotong can effectively protect the morphology of hippocampal CA1 region in gerbils. Cerebral ischemia/reperfusion injury is accompanied by cerebral vascular dysfunction. Naoxinqing Capsule can protect cerebral vascular function and inhibit cerebral ischemia/reperfusion injury. [ABSTRACT FROM AUTHOR]