PFNA与LPFP治疗老年股骨粗隆间骨折的对比分析

目的比较股骨近端防旋髓内钉(PFNA)与股骨近端锁定钢板(LPFP)治疗老年股骨粗隆间骨折的效果。方法选取60例老年股骨粗隆间骨折患者,按手术方式的不同分为两组各30例。对照组行LPFP治疗,观察组行PFNA治疗。结果观察组的手术时间、骨折愈合时间、住院时间均显著短于对照组,出血量显著少于对照组,切口长度显著小于对照组(P<0.05)。观察组的术后并发症总发生率为6.67%,显著低于对照组的30.00%(P<0.05)。观察组术后1个月、3个月的Harris评分均显著优于对照组(P<0.05)。结论 PFNA治疗老年股骨粗隆间骨折的效果显著,可加快骨折愈合,减少术后并发症,提高髋关节功能。     

PFNA与股骨近端锁定板治疗粗隆间骨折临床比较

目的:比较分析股骨近端防旋髓内钉(PFNA)与股骨近端锁定板(LPFP)治疗股骨粗隆间骨折的临床疗效.方法:选择股骨粗隆间骨折47例患者按照治疗方式的不同分为对照组(24例)和实验组(23例),两组患者分别采用股骨近端锁定板和股骨近端防旋髓内钉治疗,观察比较两组患者的临床治疗效果.结果:在手术时间、切口长度、术中出血量、术后负重时间方面,实验组均显著优于对照组(P<0.05);实验组患者的术后并发症发生率显著低于对照组患者(P<0.05);在Harris评分优良率以及骨折愈合时间方面,对照组和实验组比较差异无统计学意义(P>0.05).结论:股骨近端防旋髓内钉治疗的效果更加理想,具有微创、手术时间短、并发症发生率低、固定理想、术后恢复时间短等特点,可以将其作为首选治疗方式.     

股骨近端防旋髓内钉治疗股骨粗隆间骨折的临床分析

目的:分析股骨粗隆间骨折治疗中应用股骨近端防旋髓内钉(PFNA)治疗的疗效。方法:选取股骨粗隆间骨折患者68例,随机分为两组,对照组32例行动力髋关节螺钉(DHS),观察组36例行PFNA,对比两组疗效。结果:观察组优良率显著高于对照组,手术用时及骨折愈合时间显著短于对照组,术中出血量显著少于对照组。结论:骨近端防旋髓内钉对股骨粗隆间骨折有显著疗效,安全性高,患者术后可快速康复,值得在临床中推广。     

股骨近端抗旋髓内钉治疗老年不稳定股骨粗隆间骨折的疗效观察

目的探讨股骨近端抗旋髓内钉（PFNA）治疗老年不稳定股骨粗隆间骨折的临床疗效。方法将60例老年不稳定性股骨粗隆间骨折患者随机分为2组,分别用PFNA及动力髋螺钉（DHS）行内固定术治疗,观察两组术中、术后情况及髋关节功能恢复情况。结果与DHS组比较,PFNA组切口长度、手术时间、术中出血量、骨折愈合时间及髋关节功能改善明显优于DHS对照组,两组间比较差异有统计学意义（P〈0.05）。结论 PFNA内固定技术治疗老年不稳定性股骨粗隆间骨折安全可靠,简便实用,疗效满意。     

老年股骨粗隆间骨折患者行PFNA与DHS治疗的手术效果

目的探究股骨近端抗旋髓内钉(PFNA)以及动力髋螺钉(DHS)治疗老年股骨粗隆间骨折的临床效果。方法选取2010年1月至2014年12月在我院治疗的老年股骨粗隆间骨折患者62例,按照随机分组原则将其分为对照组和观察组,分别31例,对照组患者采用DHS治疗,观察组患者则采用PFNA进行治疗,对比两组患者的临床治疗效果以及治疗过程中的并发症发生情况。结果观察组手术时长、术中出血量、切口长度以及术后引流量均显著优于对照组;观察组骨折愈合时间、住院时长、并发症发生率均显著低于对照组;观察组术后Parker髋关节功能评定优良率明显高于对照组;差异均具有统计学意义(P<0.05)。结论在老年股骨粗隆间骨折的临床治疗中应用PFNA进行固定治疗能够显著改善患者的临床治疗效果,优化其手术治疗相关指标,值得在临床上推广应用。     

动力髋螺钉与股骨近端防旋型髓内钉治疗股骨粗隆间骨折效果对比

目的对比观察动力髋螺钉(dynamic hip screw,DHS)与股骨近端防旋型髓内钉(proximal femoral nail antirotation,PFNA)治疗股骨粗隆间骨折的效果。方法选择2014年5月—2016年5月收治的股骨粗隆间骨折患者94例,随机分为对照组、观察组各47例。对照组行DHS治疗,观察组行PFNA治疗。对比两组切口长度、术中出血量、术后引流量、手术时间、骨折愈合时间、住院时间、部分负重时间;比较两组髋关节功能、并发症。计量资料比较采用t检验,计数资料比较采用χ~2检验,P0.05为差异有统计学意义。结果对照组切口长度、术中出血量、术后引流量、手术时间、骨折愈合时间、住院时间、部分负重时间[(10.67±1.85)cm、(305.84±56.76)、(204.78±34.62)ml、(93.52±16.83)min、(15.05±1.90)、(15.23±3.45)、(42.68±5.07)d]与观察组[(5.43±1.24)cm、(200.16±42.35)、(150.39±25.17)ml、(69.48±12.41)min、(12.48±1.40)、(11.37±2.19)、(38.32±4.95)d]比较差异有统计学意义(均P0.05)。对照组优良率76.59%,观察组91.49%,两组比较差异有统计学意义(P0.05)。对照组并发症发生率17.02%,观察组4.26%,两组比较差异有统计学意义(P0.05)。结论在股骨粗隆间骨折治疗中,PFNA更具有优势,骨折愈合良好,髋关节功能恢复优良率高、并发症少。     

4种内固定方式治疗老年股骨粗隆间骨折疗效分析

目的 探讨DHS,DCS,股骨近端锁定板 PFNA四种内固定方式治疗老年股骨粗隆间骨折的临床效果.方法 对93例老年股骨粗隆间骨折采用手术治疗.其中:DHS 28例,DCS 23例,股骨近端锁定板 15例,PFNA 27例.比较手术时间、术中出血量、下地负重时间、骨折愈合时间,Harris评分等指标.结果 随诊7~24个月,PFNA组手术时间、术中出血量明显少,下地时间明显早于其它三组(P<0.05),术后并发症少.结论 PFNA在治疗老年粗隆间骨折方面明显优于DHS、DCS及股骨近端锁定板,可显著缩短手术时间,减少出血量及缩短术后负重时间.但对严重粉碎性骨折,反粗隆间骨折应慎重选择.     

动力髋螺钉和防旋股骨近端髓内钉治疗股骨近端骨折的临床疗效对比

目的:对比观察在股骨近端骨折患者中给予动力髋螺钉(DHS)、防旋股骨近端髓内钉(PFNA)治疗的疗效.方法:对2015年9月-2016年9月我院骨科收治140例股骨近端骨折患者进行观察,采用随机分组法分为观察组、对照组各70例,观察组给予PFNA治疗,对照组采用DHS治疗,随访3月,观察两组手术效果.结果:观察组切口长度、手术时间、术中出血量、住院时间、骨折愈合时间、并发症均低于对照组(P<0.05)结论:DHS、PFNA都是临床治疗股骨近端骨折的常用方法,相较于DHS手术,PFNA手术的创伤性更小,术后并发症少.     

抗螺旋刀片股骨近端髓内钉内固定闭合复位治疗股骨粗隆间骨折的疗效观察

目的探讨抗螺旋刀片股骨近端髓内钉（PFNA）内固定闭合复住治疗股骨粗隆间骨折（AO分型）的疗效。方法选取入我院就诊的股骨粗隆间骨折患者40例,随机分为观察组和对照组,各20例,观察组采取抗螺旋刀片股骨近端髓内钉（PFNA）内固定闭合复位治疗方法,对照组采取股骨近端DHS治疗方法。分析比较两组患者治疗效果、术后并发症以及患者满意度情况。结果观察组患者术中出血量、手术时间、骨折愈合时间和术后并发症发生率均明显少于对照组（P〈0．05）;观察组患者满意度显著优于对照组（P〈0．05）。结论抗螺旋刀片股骨近端髓内钉（PFNA）内固定闭合复位治疗股骨粗隆间骨折（AO分型）的疗效显著,患者满意度高,值得临床推荐应用。     

不稳定股骨粗隆间骨折时应用股骨近端防旋髓内钉(PFNA)内固定治疗选用不同体位对疗效的影响研究

目的:探讨不稳定股骨粗隆间骨折时应用股骨近端防旋髓内钉(PFNA)内固定治疗选用不同体位对疗效的影响.方法:选取我院在2017年6月至2019年6月期间收治的56例本院收治的行股骨近端防旋髓内钉(PFNA)内固定的不稳定股骨粗隆间骨折患者作为研究对象,随机编号平均分成对照组与观察组,每组28例,观察组应用仰卧位牵引床的治疗方法,对照组则采用侧卧位可透视床的治疗方法.对比两组样本疗效.结果:观察组患者的手术时间,术中出血量、切口长度、骨愈合时间、患者术后下床活动时间等指标均低于对照组,组间对比(P<0.05),统计学有意义.术后两组患者均无不良并发症的发生.结论:不稳定股骨粗隆间骨折时应用PFNA内固定治疗选用仰卧位手术创伤小,患者术后身体恢复快,具有推广价值.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.