Objective To investigate the treatment efficacy of lumbar spondylolisthesis patients with modic change. Methods The da-ta of 45 lumbar spondylolisthesis patients with modic change were analyzed retrospectively,which were admitted into hospital from January 2010 to December 2013 and received posterior lumbar interbody fusion ( PLIF) surgery. Those patients were tested by X-ray and Magnetic resonance imaging ( MRI) and confirmed the type of spondylolisthesis and Modic change. Based on the degree of spondylolysis and whether combined or not with Modic change,all the patients were divided into six groups:group A with Ⅱ grade spondylolisthesis;group B with Ⅲgrade spondylolisthesis;group C with Ⅱ grade spondylolisthesis with Modic typeⅠ;group D withⅡgrade spondylolisthesis with Modic typeⅡ;group E with Ⅲ grade spondylolisthesis with Modic type Ⅰ;group F with Ⅲ grade spondylolisthesis with Modic type Ⅱ. Those patients were evaluated preoperatively and postoperatively the scores according to the Visual Analogue Scale ( VAS) and Oswestry Disability Index ( ODI) systems,the obtained data were statistically analyzed and then were used to evaluated the treatment efficacy. Results The treatment efficacy of those patients were evaluated by follow-up work based on the scores of VAS and ODI systems,the results indicated that all those patients were improved in the scores of pain and ODI at different agrees. Within groups,the scores of low back and leg pain in VAS system and ODI preoperative were all significantly lower than that of postoperative (P<0. 0001). However,there were no significant differences of those scores among groups (P>0. 05). Conclusion Those spondylolisthesis patients with Modic change could obtained satisfactory clinical efficacy after posterior lumbar interbody fusion ( PLIF) surgery.

Objective To explore the clinical efficacy of dynamic hip screw( DHS) and proximal femoral nail anti-rotation( PFNA) in treatment of patients with Parkinson’ s disease and intertrochanteric fracture. Methods A total of 62 elderly patients of Parkinson’ s disease with femoral intertrochanteric fracture in our hospital from February 2010 to February 2014 were divided into two groups according to different internal fixations,with 31 cases in DHS group and PFNA group respectively. The operation time,X-ray fluoroscopy times,intraoperatve blood soss,the healing time of fracture,postoperative complications and Harris score between two groups were recorded and compared statistically. Results The operation time,intraoperatve blood soss and the clinical healing time of PFNA group were significantly lower than those of DHS group,the differences were statistically significant (P<0. 05). But the times of intraoperative fluoroscopy of PFNA group was more than that of DHS group,the difference was statistically significant (P<0. 05). The Harris score of hip function results showed that the excellent rate of PFNA group was significantly higher than that of DHS group, the difference was statistically significant (P=0. 034). All patients were fol-lowed up for 6 to 48 months. There were 4 cases with complications after operation in DHS group,1 cases of complications in PFNA group,the difference in complications was not significant (P>0. 05). Conclusion The PFNA has the advantages of shorter operation time,less bleed-ing,faster healing time in treatment for elderly patients with Parkinson’ s disease and intertrochanteric fracture,worth clinical promotion.

Objectives To compare the effect of one-stage revision and two-stage revision for the treatment of culture-negative peripros-thetic joint infection after total hip arthroplasty.Methods A retrospective study was conducted with the clinical data of 41 patients who had chronic periprosthetic joint infection after total hip arthroplasty and then underwent one or two-stage revision surgery from February 2006 to February 2014.The patients were divided into two groups according to different surgical way,namely the 16 patients who received the one-stage revision surgery were regarded as the OSR group,and the other 25 cases who underwent the two-stage revision surgery were regarded as the TSR group.The clinical efficacy of the two surgical way were assessed with Harris Hip score,visual analogue scale (VAS),and rate of infection clearance.Results The average duration of follow up was 29.7 months (9 to 48 months).At the last follow-up,Harris Hip score of TSR group was higher than that of the OSR group,and the difference was statistically significant (P =0.04),and the VAS score of TSR group was lower than that of the OSR group with statistical differences (P =0.02).Additionally,the rate of infection clearance in TSR group was significantly higher than OSR group (P =0.04).Conclusion Culture-negative periprosthetic joint infection can be effectively controled by one or two-stage revision surgery.However,patients got a better prognosis after two-stage revision surgery.

Objective:To explore the relevance of a new comprehensive respiratory mechanics parameter, elastic power, to the 28-day prognosis of ARDS patients.Methods:Patients with ARDS hospitalized for at least 48 h with invasive mechanical ventilation in five intensive care units in three local hospitals in Lianyungang City from June 2018 to June 2022 were included in the study. Their baseline data and respiratory mechanics parameters were collected. Elastic power, mechanical power, driving pressure and lung compliance are calculated according to the corresponding formulae. The prognostic risk factors of ARDS patients were analysed using COX multi-factor regression, and the predictive value of EP/Cst on the 28-day prognosis of ARDS patients was evaluated based on ROC curve analysis and Kaplan-Meier survival curve.Results:There was no significantly difference in tidal volume and PEEP settings between the patients in the ARDS survivor and death groups ( P> 0.05). However, the differences in respiratory rate, plateau pressure, driving pressure, lung compliance, mechanical work, elastic work, EP/cst and MP/cst between the two groups were significantly different (all P< 0.01). Multifactorial COX regression analysis showed that EP/cst ( HR=1.211, 95% CI:1.091-1.323) and RR ( HR=1.209, 95% CI:1.046-1.339) were strongly associated with a more severe degree of illness and a worse prognosis in ARDS. And the cumulative survival rate at 28 d was significantly lower in the high Cst-EP group than in the low Cst-EP group (50.00% vs. 82.40%, P < 0.01). Conclusions:The new respiratory mechanics parameters EP and EP/Cst can assess the severity of ARDS with a good predictive effect on patient prognosis at 28 days.