Objective:To assess the effect of proximal femur nail anti-rotation on the functional and radiological outcome of unstable intertrochanteric fractures.Methods:This prospective observational study was conducted in the ...Objective:To assess the effect of proximal femur nail anti-rotation on the functional and radiological outcome of unstable intertrochanteric fractures.Methods:This prospective observational study was conducted in the orthopedic department of a tertiary care hospital.Altogether 86 patients with unstable intertrochanteric fractures treated with proximal femur nail anti-rotation between January 2010 and January 2015 were included.Patients were followed in the outpatient clinic at regular intervals after discharge to assess the radiological union of fractures and complications.The functional outcomes were evaluated after 2 years by Harris hip score.Results:All patients achieved a radiological union of fractures after a mean duration of 24.6 weeks.The follow up showed 23 complications(systemic and local).Eight patients developed urinary tract infections,and three patients developed chest infections,two patients had screw cut-out,one patient had knee stiffness,one patient developed superficial surgical site infection,and four patients developed varus collapse and shortening subsequently.The two year follow up showed that 69(80.2%)patients had an excellent and good functional outcome according to Harris hip score.Conclusions:With lower complication rates,proximal femur nail is a valid and reasonable option especially in treating unstable intertrochanteric fractures.展开更多
An accurate method to solve the daynes Cummings （J-C） Hamiltonian has been investigated here. The phenomenon of atomic collapse and revival predicted by Jaynes-Cummings model is demonstrated. Solutions are consis- t...An accurate method to solve the daynes Cummings （J-C） Hamiltonian has been investigated here. The phenomenon of atomic collapse and revival predicted by Jaynes-Cummings model is demonstrated. Solutions are consis- tent with the precious such as using the operator method. Furthermore, the Jaynes-Cummings Hamiltonian including the anti-rotating term is also solved precisely using this accurate way so that results agree with experiments better. Essences of the anti-rotating term are revealed. We discuss the relations of the phenomenon of atomic collapse and revival with the average photons number, the light field phase angle, the resonant frequency, and the size of coupling constant. The discussions may make one select suitable conditions to carry out experiment well and study the virtual light field effect on cavity quantum electrodynamics.展开更多
Objective To investigate the operative method and evaluate the clinical outcomes of long proximal femoral nail anti-rotation (PFNA-long) in treating long-segment fracture in middle-up part of femoral bone.Methods From...Objective To investigate the operative method and evaluate the clinical outcomes of long proximal femoral nail anti-rotation (PFNA-long) in treating long-segment fracture in middle-up part of femoral bone.Methods From June 2006 to展开更多
Purpose: The proximal femoral nail anti-rotation (PFNA) is known to have advantages in enhancing the anchorage ability of internal fixation in elderly unstable osteoporotic intertrochanteric fracture patients. However...Purpose: The proximal femoral nail anti-rotation (PFNA) is known to have advantages in enhancing the anchorage ability of internal fixation in elderly unstable osteoporotic intertrochanteric fracture patients. However whether it is superior to condylar blade fixation is not clear. This study aimed to determine which treatment has better clinical outcomes in older patients. Materials and Methods: A total of 86 patients over the age of 60 with unstable trochanteric fractures within the past 3 weeks, were included in this prospective study conducted from June 1, 2018, to May 31, 2021. All the intertrochanteric fractures were classified according to AO/OTA classification. Among them, 44 cases were treated with the Proximal Femoral Nail (PFNA2) with or without an augmentation screw, and 42 cases were treated with the Condylar Blade Plate. In addition, the operative time, intraoperative blood loss, intraoperative and postoperative blood transfusion, postoperative weight-bearing time, hospitalization time, Harris score of hip function, Kyle’s criteria and postoperative complications were compared between the two groups. Results: The mean duration of surgery for the PFN group was 66.8 minutes (on average), whereas for the condylar blade plate group, it was 99.30 minutes (on average). The PFNA2 group experienced less blood loss (average of 80 mL) compared to the condylar blade plate group (average of 120 mL). Union and partial weight-bearing occurred earlier in the PFNA2 group (14.1 weeks and 10.6 weeks, respectively) compared to the Condylar blade plate group (18.7 weeks and 15.8 weeks). In two patients from the PFNA2 group, screw backing out and varus collapse complications were encountered;however, these patients remained asymptomatic and did not require revision surgery. In two other patients, screw cut out and breakage of the nail at the helical screw hole leading to non-union of the proximal femur were observed during the nine-month follow-up, necessitating revision surgery with prosthetic replacement. Among the condylar blade plate group, three patients experienced complications, including blade breakage at the blade and plate junction. In two cases, the fracture united in varus, and in one case, the blade cut through, resulting in non-union of the femoral head, which required revision surgery. According to the Harris hip score and Kyle’s criteria, a good-excellent outcome was observed in 92.85% of cases in the PFNA2 group and 90.90% of cases in the condylar blade plate group. Conclusion: Both the Proximal Femoral Nail A2 and Condylar blade plate are effective implants for the treatment of unstable trochanteric fractures. The intramedullary implant promotes biological healing and allows for early ambulation with minimal complications. Similarly satisfactory restoration of anatomy and favorable radiological and functional results can be achieved with the biological fixation provided by the 95-degree condylar blade plate. However, the use of PFNA2 internal fixation technique has the advantage of less trauma in elderly patients than the 95-degree condylar blade plate.展开更多
Intertrochanteric fractures have become a severe public health problem in elderly patients.Proximal femoral nail anti-rotation(PFNA)is a commonly used intramedullary fixation device for unstable intertrochanteric frac...Intertrochanteric fractures have become a severe public health problem in elderly patients.Proximal femoral nail anti-rotation(PFNA)is a commonly used intramedullary fixation device for unstable intertrochanteric fractures.Pelvic perforation by cephalic screw is a rare complication.We reported an 84-year-old female who fell at home and sustained an intertrochanteric fracture.The patient underwent surgery with PFNA as the intramedullary fixation device.Routine postoperative examination revealed medial migration of the helical blade that eventually caused pelvic perforation.We performed a cemented total hip arthroplasty as the savage procedure.At the latest follow-up of 12 months after total hip arthroplasty,the patient had no pain or loosening of the prosthesis in the left hip.Pelvic perforation should be considered when choosing PFNA as the intramedullary fixation device,especially in patients with severe osteoporosis wherein the helical blade can be easily inserted during the operation.The lack of devices to avoid oversliding of the helical blade in PFNA is an unreported cause of this complication and should be considered in such cases.展开更多
研究了牛蒡叶中抑制木腐菌活性成分的快速提取工艺及其提取物对木材腐朽菌的抑制性能。在以彩绒革盖菌为提取物抑菌效果指示菌的提取预实验以及以提取率为指标的单因素实验基础上,采用响应曲面法对牛蒡叶中活性成分进行优化提取,确定最...研究了牛蒡叶中抑制木腐菌活性成分的快速提取工艺及其提取物对木材腐朽菌的抑制性能。在以彩绒革盖菌为提取物抑菌效果指示菌的提取预实验以及以提取率为指标的单因素实验基础上,采用响应曲面法对牛蒡叶中活性成分进行优化提取,确定最优提取方式和对木材腐朽菌(彩绒革盖菌和密粘褶菌)的抑制能力,并通过Accela U-HPLC高速液相色谱系统分离和鉴定优化条件下提取物中的活性成分。结果表明:在预实验中,酸性水提取物的抑菌效果要优于其他方式;经过响应曲面四因素三水平优化后,在液料比30 m L/g、提取温度52℃、提取时间77 min和溶剂pH值2.0条件下,理论提取率达到45.81%,经验证此条件下的平均提取率为44.86%,与模型理论值差异为-2.08%;此条件下的提取物,比预实验中采用酸性水方式获得的提取物抑制白腐菌的效果提高了16.47%;在此条件下获取的提取物,经U-HPLC-MS分离并鉴定出12种具有抑菌活性的成分,分别为有机酸类(奎宁酸、原儿茶酸、异绿原酸A、异绿原酸B、异绿原酸C、二聚绿原酸、绿原酸、4,5-二咖啡酰奎尼酸)、黄酮类(牛蒡酮-a)、苷类(芦丁、5'-Propanediolmatairesinoside)、萜类(β-桉叶醇)。经验证,响应曲面优化后得到的提取物对彩绒革盖菌和密粘褶菌均具有良好的广谱抑菌能力,其对两种菌的最低抑菌质量分数分别为1.88%和2.31%。展开更多
文摘Objective:To assess the effect of proximal femur nail anti-rotation on the functional and radiological outcome of unstable intertrochanteric fractures.Methods:This prospective observational study was conducted in the orthopedic department of a tertiary care hospital.Altogether 86 patients with unstable intertrochanteric fractures treated with proximal femur nail anti-rotation between January 2010 and January 2015 were included.Patients were followed in the outpatient clinic at regular intervals after discharge to assess the radiological union of fractures and complications.The functional outcomes were evaluated after 2 years by Harris hip score.Results:All patients achieved a radiological union of fractures after a mean duration of 24.6 weeks.The follow up showed 23 complications(systemic and local).Eight patients developed urinary tract infections,and three patients developed chest infections,two patients had screw cut-out,one patient had knee stiffness,one patient developed superficial surgical site infection,and four patients developed varus collapse and shortening subsequently.The two year follow up showed that 69(80.2%)patients had an excellent and good functional outcome according to Harris hip score.Conclusions:With lower complication rates,proximal femur nail is a valid and reasonable option especially in treating unstable intertrochanteric fractures.
基金Supported by the Natural Science Foundation of Hunan Province under Grant No.09JJ6011the Natural Science Foundation of Education Department of Hunan Province under Grant Nos.10A100 and 07C528
文摘An accurate method to solve the daynes Cummings （J-C） Hamiltonian has been investigated here. The phenomenon of atomic collapse and revival predicted by Jaynes-Cummings model is demonstrated. Solutions are consis- tent with the precious such as using the operator method. Furthermore, the Jaynes-Cummings Hamiltonian including the anti-rotating term is also solved precisely using this accurate way so that results agree with experiments better. Essences of the anti-rotating term are revealed. We discuss the relations of the phenomenon of atomic collapse and revival with the average photons number, the light field phase angle, the resonant frequency, and the size of coupling constant. The discussions may make one select suitable conditions to carry out experiment well and study the virtual light field effect on cavity quantum electrodynamics.
文摘Objective To investigate the operative method and evaluate the clinical outcomes of long proximal femoral nail anti-rotation (PFNA-long) in treating long-segment fracture in middle-up part of femoral bone.Methods From June 2006 to
文摘Purpose: The proximal femoral nail anti-rotation (PFNA) is known to have advantages in enhancing the anchorage ability of internal fixation in elderly unstable osteoporotic intertrochanteric fracture patients. However whether it is superior to condylar blade fixation is not clear. This study aimed to determine which treatment has better clinical outcomes in older patients. Materials and Methods: A total of 86 patients over the age of 60 with unstable trochanteric fractures within the past 3 weeks, were included in this prospective study conducted from June 1, 2018, to May 31, 2021. All the intertrochanteric fractures were classified according to AO/OTA classification. Among them, 44 cases were treated with the Proximal Femoral Nail (PFNA2) with or without an augmentation screw, and 42 cases were treated with the Condylar Blade Plate. In addition, the operative time, intraoperative blood loss, intraoperative and postoperative blood transfusion, postoperative weight-bearing time, hospitalization time, Harris score of hip function, Kyle’s criteria and postoperative complications were compared between the two groups. Results: The mean duration of surgery for the PFN group was 66.8 minutes (on average), whereas for the condylar blade plate group, it was 99.30 minutes (on average). The PFNA2 group experienced less blood loss (average of 80 mL) compared to the condylar blade plate group (average of 120 mL). Union and partial weight-bearing occurred earlier in the PFNA2 group (14.1 weeks and 10.6 weeks, respectively) compared to the Condylar blade plate group (18.7 weeks and 15.8 weeks). In two patients from the PFNA2 group, screw backing out and varus collapse complications were encountered;however, these patients remained asymptomatic and did not require revision surgery. In two other patients, screw cut out and breakage of the nail at the helical screw hole leading to non-union of the proximal femur were observed during the nine-month follow-up, necessitating revision surgery with prosthetic replacement. Among the condylar blade plate group, three patients experienced complications, including blade breakage at the blade and plate junction. In two cases, the fracture united in varus, and in one case, the blade cut through, resulting in non-union of the femoral head, which required revision surgery. According to the Harris hip score and Kyle’s criteria, a good-excellent outcome was observed in 92.85% of cases in the PFNA2 group and 90.90% of cases in the condylar blade plate group. Conclusion: Both the Proximal Femoral Nail A2 and Condylar blade plate are effective implants for the treatment of unstable trochanteric fractures. The intramedullary implant promotes biological healing and allows for early ambulation with minimal complications. Similarly satisfactory restoration of anatomy and favorable radiological and functional results can be achieved with the biological fixation provided by the 95-degree condylar blade plate. However, the use of PFNA2 internal fixation technique has the advantage of less trauma in elderly patients than the 95-degree condylar blade plate.
基金National Key R&D Program of China,2018YFF0301103,The funding body will support the publication fees without affecting the diagnosis and treatment of the patient and the writing of the manuscript.
文摘Intertrochanteric fractures have become a severe public health problem in elderly patients.Proximal femoral nail anti-rotation(PFNA)is a commonly used intramedullary fixation device for unstable intertrochanteric fractures.Pelvic perforation by cephalic screw is a rare complication.We reported an 84-year-old female who fell at home and sustained an intertrochanteric fracture.The patient underwent surgery with PFNA as the intramedullary fixation device.Routine postoperative examination revealed medial migration of the helical blade that eventually caused pelvic perforation.We performed a cemented total hip arthroplasty as the savage procedure.At the latest follow-up of 12 months after total hip arthroplasty,the patient had no pain or loosening of the prosthesis in the left hip.Pelvic perforation should be considered when choosing PFNA as the intramedullary fixation device,especially in patients with severe osteoporosis wherein the helical blade can be easily inserted during the operation.The lack of devices to avoid oversliding of the helical blade in PFNA is an unreported cause of this complication and should be considered in such cases.
文摘研究了牛蒡叶中抑制木腐菌活性成分的快速提取工艺及其提取物对木材腐朽菌的抑制性能。在以彩绒革盖菌为提取物抑菌效果指示菌的提取预实验以及以提取率为指标的单因素实验基础上,采用响应曲面法对牛蒡叶中活性成分进行优化提取,确定最优提取方式和对木材腐朽菌(彩绒革盖菌和密粘褶菌)的抑制能力,并通过Accela U-HPLC高速液相色谱系统分离和鉴定优化条件下提取物中的活性成分。结果表明:在预实验中,酸性水提取物的抑菌效果要优于其他方式;经过响应曲面四因素三水平优化后,在液料比30 m L/g、提取温度52℃、提取时间77 min和溶剂pH值2.0条件下,理论提取率达到45.81%,经验证此条件下的平均提取率为44.86%,与模型理论值差异为-2.08%;此条件下的提取物,比预实验中采用酸性水方式获得的提取物抑制白腐菌的效果提高了16.47%;在此条件下获取的提取物,经U-HPLC-MS分离并鉴定出12种具有抑菌活性的成分,分别为有机酸类(奎宁酸、原儿茶酸、异绿原酸A、异绿原酸B、异绿原酸C、二聚绿原酸、绿原酸、4,5-二咖啡酰奎尼酸)、黄酮类(牛蒡酮-a)、苷类(芦丁、5'-Propanediolmatairesinoside)、萜类(β-桉叶醇)。经验证,响应曲面优化后得到的提取物对彩绒革盖菌和密粘褶菌均具有良好的广谱抑菌能力,其对两种菌的最低抑菌质量分数分别为1.88%和2.31%。
