BACKGROUND:Bone loss to different degrees may appear within 1 year after hip replacement in the femoral or acetabular sides, and severely affect long-term stability of the prosthesis and bone strength. Thus, to reduce bone loss around the prosthesis stem after total hip replacement is significant to prolong the use time of the prosthesis and to prevent fractures surrounding the prosthesis.
OBJECTIVE:To observe the preventive effect of zoledronic acid on bone loss surrounding the prosthesis stem after hip replacement.
METHODS:A total of 80 patients after total hip replacement in the People’s Hospital of Shenxian from February 2011 to September 2014 were enrol ed in this study. They were divided into two groups (n=40). At 4 days after replacement, patients in the observation group received treatment with zoledronic acid, but those in the control group did not give zoledronic acid. The rest medication was identical between the two groups. Bone mineral density in the hip was measured before replacement and at 1 year after replacement in both groups. Serum calcium and
phosphorus levels and alkaline phosphatase activities were observed before replacement, 3 days and 1 year after medication in the two groups. Adverse reaction during medication was recorded in the observation group.
RESULTS AND CONCLUSION:The average bone mineral density was significantly decreased in both groups at 1 year after replacement, and significant differences were found as compared with before replacement (P<0.05). The average bone mineral density was significantly higher in the observation group than in the control group at 1 year after
replacement (P<0.05). Calcium and phosphorus levels were significantly diminished at 3 days after medication as compared with that before replacement (P<0.05). Calcium and phosphorus levels maintained at the level before replacement at 1 year after medication. Alkaline phosphatase activities were slightly reduced within a short time after replacement in both groups, but no significant difference was found as compared with before replacement (P>0.05). Alkaline phosphatase activities were low in the observation group at 1 year after medication, and significant difference was detected as compared with the control group and that before replacement (P<0.05). No significant difference in alkaline phosphatase activities was detectable in the control group between 1-year post medication and pre-replacement (P>0.05). Within two or three days after medication, nine patients suffered from varying degrees of muscle aches and fever in the observation group, and above symptoms were lessened after taking acetaminophen. These results verify that after total hip replacement, zoledronic acid injection can effectively prevent bone loss around the prosthesis in early stage after replacement, but fever symptoms may occur within a week after replacement. Thus, it is recommended that zoledronic acid injection can be given at 1 week after replacement. If fever and other symptoms appear, acetaminophen can be given.

Objective:To evaluate the clinical efficacy of Wenyang Huoxue Jiedu Decoction combined with trimetazidine tablets in the treatment of patients with acute myocardial infarction (AMI) after interventional therapy.Methods:A total of 90 patients with AMI of syndrome of cold coagulation of heart vein after interventional surgery in the angshan Hongci Hospital , who met the inclusion criteria were enrolled between February 2020 and April 2021, and they were divided into two groups by the random number table method, with 45 in each group. The control group was given conventional western medicine treatments such as anti-coagulation, lipid regulation and oral administration of trimetazidine tablets, while the observation group adopted Wenyang Huoxue Jiedu Decoction on the basis of the control groups. Both groups were treated for 2 weeks. Before and after treatment, TCM symptoms were scored, and serum creatine kinase isoenzyme (CK-MB), cardiac troponin T (cTnT) and myoglobin (MYO) were detected by ELISA. Left ventricular ejection fraction (LVEF), stroke volume (SV) and left ventricular end-systolic diameter (LVESD) were detected by color ultrasonic instrument, and the clinical efficacy was evaluated. Results:The effective rate was 95.6% (43/45) in the observation group and that in the control group was 88.9% (40/45) ( χ2=1.39, P=0.238). The scores of excruciating pain in the chest, wheezing and incapability of supination, chest tightness and shortness of breath and palpitation in the observation group were significantly lower than those in the control group ( t=5.07, 3.43, 4.98, 5.15, P<0.01). After treatment, the levels of CK-MB [(47.62±8.31) U/L vs. (53.49±8.27) U/L, t=3.36], cTnT [(0.48±0.16) μg/L vs. (0.63±0.25) μg/L, t=3.39] and MYO [(125.47±25.63) μg/L vs. (163.28±30.17) μg/L, t=6.41] were significantly lower in the observation group compared to the control group ( P<0.01). The LVESD [(42.15±7.04) mm vs. (46.03±7.26) mm, t=2.57] in the observation group after treatment was significantly lower than that of the control group ( P<0.05), while the LVEF [(56.73±8.34)% vs. (52.49±8.26)%, t=2.42] and SV [(71.58±4.31) ml vs. (65.47±4.23) ml, t=6.79] were significantly higher than those in the control group ( P<0.05 or P<0.01). Conclusion:Wenyang Huoxue Jiedu Decoction combined with trimetazidine tablets can improve the cardiac function, alleviate the myocardial injury, relieve symptoms of patients with AMI of syndrome of cold coagulation of heart vein after interventional surgery.

Objective To study the value of ultrasound in operation for traumatic brain injury (TBI) in simulation field hospitals where computed tomography (CT) equipment is unavailable.Methods The wartime conditions were simulated, and the patients at age of 18-60 years were randomly selected.According to the principles of medical ethics, all patients received CT scanning.Two neurosur-geons from the field hospital who did not know the result of CT examination cooperated with another two neurosurgeons who got the results of the CT examination to determine whether operation should be ap-plied.Forty-five patients who needed emergency craniotomy were finally selected.The operations were performed by two neurosurgeons from the field hospital, with real-time ultrasound monitoring.The results of ultrasound were compared with that of CT scanning.Results A total of 64 lesions were found by ul-trasound , and 60 of which should be treated by operation.In the meantime, 82 lesions were found by CT scanning, 64 of which should be treated operatively.Epidural hematoma and subdural hematoma had high ultrasound detection rate, followed by intracerebral hematoma, subdural effusion and brain contusion.The overall detection rate of ultrasound was 87.1%.Conclusion Ultrasound plays an important role in correctly finding the focus so as to reduce blind operation and avoid omission of the focus in field hospi-tals, where CT equipment is usually unavailable.