Objective To investigate the impact of rivaroxaban and low molecular weight heparin on hidden blood loss after unilateral first half artificial hip replacement surgery.Methods According to the digital table,a total of 80 cases because of femoral neck fractures in elderly patients with unilateral arthroplasty artificial hip and a half after surgery were randomly divided into the rivaroxaban group and low molecular weight heparin (LMWH) group,40 cases in each group.In both groups,respectively,after 12 h begin daily oral rivaroxaban 10 mg and subcutaneous low molecular weight heparin 5 000 u,compared the two groups around the actual amount of perioperative blood loss,blood loss was dominant,recessive blood loss and hidden blood loss accounts,the actual percentage of total blood loss,and recorded 35d bleeding events.Results The total amount of blood loss,dominant blood loss,hidden blood loss and the hidden blood loss accounted for the actual percentage of the total amount of blood loss of the rivaroxaban group were (671.00 ± 55.61) mL,(313.88 ± 14.53) mL,(350.00 ± 29.41) mL,(52.00 ± 5.22) ％,respectively,which of the the LMWH group were (662.00 ± 30.19) mL,(288.87 ± 15.33) mL,(372.00 ± 35.10) mL,(56.00 ± 6.71) ％,there were no significant differences between the two groups (t =0.93,0.93,0.83,1.03,all P ＞ 0.05).Conclusion For patients first underwent unilateral hip replacement surgery artificial half,perioperative using rivaroxaban or LMWH has no significantly differences in hidden risk of bleeding and bleeding event rate.

Objective:To explore the effect of enhanced recovery nursing based on traditional Chinese medicine nursing operation technology in the perioperative period of elderly patients with total hip arthroplasty.Methods:From January 2020 to December 2021, 90 patients with unilateral total hip arthroplasty in Wenzhou Traditional Chinese Medicine Hospital were selected by convenience sampling as research objects. The patients from January to December 2020 were taken as the control group ( n=43) , and the patients from January to December 2021 were taken as the observation group ( n=47) . The patients in the control group adopted the traditional orthopedic perioperative nursing, while the patients in the observation group received the enhanced recovery perioperative nursing based on traditional Chinese medicine nursing operation technology on the basis of the control group. The pain, postoperative recovery and complications were compared between the two groups. Results:The time of first exhaust, eating, getting out of bed and hospital stay after operation in the observation group were shorter than those in the control group, the Visual Analogue Scale (VAS) score at discharge was lower than that in the control group, and the incidence of postoperative gastrointestinal reactions and postoperative urinary retention were lower than those in the control group, with statistically significant differences ( P<0.01) . Conclusions:The enhanced recovery nursing based on traditional Chinese medicine nursing operation technology applied to elderly patients with unilateral total hip arthroplasty during perioperative period can reduce postoperative complications, pain and hospital stay, which is worthy of clinical promotion.

Objective: To analyze the comprehensive intervention effect of post-traumatic stress disorder (PTSD) in patients with acute hand injury, and its correlation with hand function recovery. Methods: A total of 120 patients with hand trauma admitted to Wenzhou Hospital of Traditional Chinese Medicine from April 2016 to April 2018 were selected.The patients were randomly divided into observation group (60 cases) and control group (60 cases) according to the digital table.The observation group received routine treatment and comprehensive intervention.The control group was given routine treatment.The PDST scale (CAPS), depression self-rating scale (SDS) and Hamilton anxiety scale (HAMA) rating scale used by clinicians were used to assess the psychological status, depression and anxiety of patients with PTSD, and to evaluate the upper limb function of patients. Results: After intervention, the scores of CAPS, SDS and HAMA in the control group were (24.51±8.43)points, (50.61±7.59)points and (10.63±2.11)points, respectively, which were significantly higher than those in the observation group[(16.53±7.62)points, (40.26±4.18)points, (8.24±1.86)points](t=5.61, 5.59, 4.73, all P<0.05). The CAPS, SDS and HAMA scores of the two groups were significantly improved compared with before intervention (t=4.11, 5.04, 3.98, 5.18, 3.86, 4.72, all P<0.05). After intervention, the upper limb function scale (DASH) scores of the observation group and the control group were (89.27±6.08)points and (82.11±7.92)points, respectively.The DASH scores of the two groups were significantly higher than those before intervention (t=6.14, 5.28, all P<0.05). The DASH score of the observation group was superior to the control group (t=3.96, P<0.05). The DASH score of patients with hand injury was negatively correlated with CAPS score and SDS score (r=-0.362, -0.425, P=0.012, 0.008). Conclusion Comprehensive intervention for PTSD in patients with acute hand injury can significantly improve the degree of depression and anxiety, and improve the upper limb function of patients.