RESUMO
Objective:To explore the efficacy of long intramedullary nails versus short intramedullary nails in the treatment of AO/OTA 31-A3 intertrochanteric fractures.Methods:A retrospective analysis was conducted on 60 patients with AO/OTA 31-A3 intertrochanteric femur fractures treated between March 2019 and August 2022. The patients were randomly divided into two groups (the long nail group and the short nail group). Thirty-four patients were treated with long intramedullary nails, including 16 males and 18 females, aged 68.41±17.84 years old (range 31-96 years). Twenty-six patients were treated with short intramedullary nails, including 13 males and 13 females, aged 72.23±13.97 years old (range 31-90 years). The causes of injury, fracture classification (AO/OTA classification), intraoperative blood loss, operation time, fracture healing time, imaging indexes (fracture reduction quality, postoperative neck trunk angle, and medial support), Harris score of the hip joint at the last follow-up, one-year mortality rates and complications were compared between the two groups.Results:The follow-up time was 24.26±6.67 months in the long nail group and 24.31±5.60 months in the short nail group, and the general information of the two groups were comparable. Between the long nail and short nail group, the intraoperative blood loss was 281.47±235.28 ml vs. 121.92±84.14 ml and the operation time was 110.44±24.63 min vs. 81.15±28.54 min with significant differences ( P<0.05). While the length of hospital stay was 12.35±4.81 d vs. 10.89±4.30 d, the good rate of fracture reduction was 55.9% vs. 61.53%, the fracture healing time was 120.44±16.43 d vs. 128.07±18.33 d, the presence rate of medial support was 67.6% vs. 79.4%, and the excellent rate of Harris score was 65.4% vs. 65.4% with no significant difference between the two groups ( P>0.05). One-year mortality rates was 5.3% vs. 7.1% and complications was 11.7% vs. 15.4% with no significant difference between the two groups ( P>0.05). Conclusion:Both long intramedullary nails and short intramedullary nails are effective in the treatment of AO/OTA 31-A3 intertrochanteric femur fractures. However, surgical time and intraoperative blood loss was less in the short nail group.
RESUMO
Objective To investigate the value of echocardiography for assessing the right ventricular function before and af ter treatment in the patients with pulmonary embolism.Methods Ninety-six patients with pulmonary embolism in our hospital from June 2014 to December 2015 were selected as the research subjects and divided into low-risk group,intermediate-risk group and high-risk group according to the disease severity.The echocardiographic examination was performed before and after treatment in all cases.Results The pulmonary artery systolic pressure after treatment in the low-risk group was lower than that before treatment (P＜0.05).The transverse diameter of right ventricle,transverse diameter of right ventricle and pulmonary artery systolic pressure after treatment in the intermediate-risk group and high-risk group were lower than those before treatment (P＜0.05).The Tei index after treatment in the low-risk group,intermediate-risk group and high-risk group was lower than that before treatment (P＜ 0.05).The right ventricle ejection fraction (RVEF),right ventricular end-systolic volume (RVESV) and right ventricular end-dias tolic volume (RVEDV) in the low-risk group had no statistically significant difference between before and after treatment.RVEF after treatment in the intermediate-risk group and high-risk group was higher than that before treatment(P＜0.05),while RVESV and RVEDV after treatment were lower than those before treatment (P＜0.05).Conclusion Echocardiography can objectively re flect the change situation of right heart function before and after treatment in the patients with pulmonary embolism,and can be used as an evaluation method for the effect of pulmonary embolism treatment.
RESUMO
Objective To analyze the factors that influence the articular function after open reduction and internal fixation for ankle fractures.Methods From July 2014 to January 2016,111 ankle fractures received surgery in our hospital.There were 54 males and 57 fenales,with a mean age of 43.5 years (frown 18 to 75 years).By the Broos & Bisschop classification,there were 43 unimalleolar,38 bimalleolar and 30 trimalleolar fractures.The postoperative articular function was evaluated according to the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scoring at the final follow-up.Comparisons were made between the patients with excellent functional scores and those with lower than excellent functional scores.The potential influencing factors were analyzed,including age,gender,body mass index,smoking history,primary hypertension history,diabetes history,injured side,fracture cause,Broos & Bisschop classification,combined presence of obvious inferior tibiofibular separation,combined presence of ankle dislocation,combined presence of other injury,time from injury to surgery,physical status classification by the American Society of Anesthesiologists system,operation time,early functional exercise,removal of internal fixation and postoperative complications.The influencing factors were identified using univariate analysis and logistic regression analysis.Results The average follow-up period was 15.5 months (from 8 to 25 months).The clinical union time of the fractures averaged 3.2 months (from 3 to 5 months).The ankle function at the final follow-up was excellent in 58 cases,good in 48,fair in 5 and poor in 0,with an excellent and good rate of 95.5％.Removal of internal fixation (P =0.001),early functional exercise (P =0.002),and postoperative complications (P =0.049) were identified as the independent risk factors influencing the articular function after surgery for ankle fractures.Conclusion For patients with ankle fracture,enhancing intraoperative procedures,reducing postoperative complications,encouraging the patients to do early functional exercise,and removing internal fixation after firacture union can effectively improve their ankle function.
RESUMO
Objective To analyze the factors that influence the articular function after open reduction and internal fixation for ankle fractures.Methods From July 2014 to January 2016,111 ankle fractures received surgery in our hospital.There were 54 males and 57 fenales,with a mean age of 43.5 years (frown 18 to 75 years).By the Broos & Bisschop classification,there were 43 unimalleolar,38 bimalleolar and 30 trimalleolar fractures.The postoperative articular function was evaluated according to the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scoring at the final follow-up.Comparisons were made between the patients with excellent functional scores and those with lower than excellent functional scores.The potential influencing factors were analyzed,including age,gender,body mass index,smoking history,primary hypertension history,diabetes history,injured side,fracture cause,Broos & Bisschop classification,combined presence of obvious inferior tibiofibular separation,combined presence of ankle dislocation,combined presence of other injury,time from injury to surgery,physical status classification by the American Society of Anesthesiologists system,operation time,early functional exercise,removal of internal fixation and postoperative complications.The influencing factors were identified using univariate analysis and logistic regression analysis.Results The average follow-up period was 15.5 months (from 8 to 25 months).The clinical union time of the fractures averaged 3.2 months (from 3 to 5 months).The ankle function at the final follow-up was excellent in 58 cases,good in 48,fair in 5 and poor in 0,with an excellent and good rate of 95.5％.Removal of internal fixation (P =0.001),early functional exercise (P =0.002),and postoperative complications (P =0.049) were identified as the independent risk factors influencing the articular function after surgery for ankle fractures.Conclusion For patients with ankle fracture,enhancing intraoperative procedures,reducing postoperative complications,encouraging the patients to do early functional exercise,and removing internal fixation after firacture union can effectively improve their ankle function.
RESUMO
Objective To evaluate the clinical outcomes of induced membrane technique in the treatment of traumatic segmental bone defects.Methods From May 2011 to January 2016,we treated 10 patients with traumatic segmental bone defect of the lower limb.They were 7 men and 3 women,with an average age of 41.6 years (from 18 to 61 years.The bone defects involved 8 tibias and 2 femurs;the mean length of the bone defects was 5.1 cm (from 2 to 15 cm).All the segmental bone defects were teated by induced membrane technique.At the first stage,the bone defects were filled with antibiotic-impregnated cement spacer after thorough debridement,the limb was fixated with external fixtor,and soft tissue repair was performed in 5 patients.On average all the patients received emergency treatment at the first stage 8.1 hours (from 4 to 13 hours) after trauma.At the second stage,after the cement was removed,the bone defects were filled with cancellous autografts.An allograft was used when the autograft was not adequate enough.The external fixtor was exchanged by internal fixation in one patient according to his soft tissue condition and will;the exteranl fixation was retained in the other 9 patients.Results The average follow-up was 2.8 years (from 1.0 to 5.5 years).Bone healing was achieved in 9 patients after an average of 7.1 months (from 5 to 9 months),and nonunion happened in one patient whose bone graft had been not sufficient enough.Stress fracture occurred in one patient 7 months after bone healing,but it responded to conservative management.One patient reported numbness on the anterolateral thigh of the donor site.Pin tract infection occurred in 3 patients.Follow-ups revealed no limb length discrepancy or deep infection.Conclusion Induced membrane technique is a simple and reliable technique for the treatment of traumatic segmental bone defects.
RESUMO
MicroRNA (miRNA) is a family of endogenous single-stranded RNA about 22 nucleotides in length. Through targeting 3' UTR of message RNA (mRNA), they play important roles in post-transcriptional regulatory functions. For further research of miRNA function, the identification of more miRNA positive targets is needed urgently. Aiming at the high-dimensional small sample data sets in miRNA target prediction, an algorithm of eliminating redundant features is proposed based on v-SVM in this paper, and classification and features selection are also fused. The algorithm of eliminating redundant features optimizes the combination of features, and then constructs the best features combination which can represent miRNA and targets interaction model. The prior parameter v (0 < u < or = 1) controls the compression proportion of data set and selects more distinguishing support vectors. Finally, the classifier model of miRNA target prediction is built. The unbiased assessment of the classifier is achieved with a completely independent test dataset. Experiment results indicated that in both classification recognition and generalization performance of miRNA targets predicition, this model was superior to the present machine learning algorithms such as miTarget, NBmiRTar and TargetMiner, etc.