ObjectiveTo compare the effect of the neurosurgical clipping and endovascular for treating intracranial aneurysm.MethodsRetrospectively analyzed the clinical data of 110 cases with intracranial aneurysms.The patients were divided into intervention group(55 patients with endovascular treatment) and surgery group(55 patients with neurosurgical clipping treatment) according to different methods,followed forup 1 ～4 months,and immediately evaluated the efficacy.The Chinese stroke scale(CSS) and activities of daily living(ADL) score were used for prognostic evaluation.ResultsThe immediate effect:the marked efficacy in 40 cases,efficacy in 10 cases and inefficacy in 5 cases,and the total effective rate in the intervention group was 90.9％,while the surgery group were 32 cases,10 cases,13 cases,and the total effective rate was 76.4％.There was significantl differences between the two groups ( x2 =3.96,P ＜ 0.05 ) ; the CSS and ADL scores significantly lower than pre-treatment ( t =9.12,8.05,P ＜0.05).ConclusionEndovascular treatment for intracranial aneurysms could improve the clinical efficacy and improve patients self-care ability,and significantly improve the prognosis.

Objective To investigate the value of neuronavigation system in resection of pituitary adenoma through the endonasal transsphenoidal approach. Methods Twenty-one patients with pituitary adenomas underwent magnetic resonance imaging (MRI) or CT scans studies. The image datasets were transported into the neuronavigation system. The anatomic information of approach was reconstructed for three-dimensional visualization and the best approach was designed. The midline structure and internal carotid artery were displayed in real-time intraoperatively, the anterior-wall of sphenoidal sinus and the floor of sella were accurately opened and the tumor was resected guiding by neuronavigation system. Results All the operations were smoothly and accurately performed under the neuronavigation by transsphenoidal approach. No injury occurred in the internal carotid artery and cavernous sinus. After surgery, 13 patients got better vision and visual field. Postoperative transient diabetes insipidus was found in 11 cases, and CSF leak in 1 and serious hyponatremia in 2 cases. Total tumor removal was achieved in 17 patients and subtotal removal in 2 cases during operations, which were confirmed by postoperative MRI. Three-month follow-up data showed only one recurrence case (subtotal tumor removal), the recurrence rate was 4.8%. Conclusion Neuronavigation system provided real-time localization with three-dimensional anatomic information of the endonasal transsphenoidal approach during pituitary adenomas surgery. As a result, the approach proceeds more smoothly and accurately, the tumor can be resected more completely, the surgical injury and complications can also be reduced.

ObjectiveTo discuss the role of neuronavigaition technique in localizing and facilliating microsurgical resection of intracranial ateriovenous malformations (AVM) .Methods Forty-three cases with intracranial AVM treated microneurosurgically asisting by Stryker Leibinger neuronavigation system were retrospectively analyzed.Results After reaching neuronavigation calculated technical accuracy (less than 2 mm) and continual intraoperative navigating accuracy, all of the 43 AVM lesions were completely resected.In 41 patients, syptoms were significantly improved (95.4％) at discharge, new neurofuntion defection were found in 2 patients(4.6％) , no death occured.ConclusionNeuronavigation techniques helps the surgery in planning a precise surgical approach to the targeted AVM lesion and tracing the neurovascular structures ,improves the safety of the surgery and the functional outcome of the patients, contribute to lesion resection and reduce operative complications.

objective To explore the application of navigation-assited microsurgery resection of posterior fossa solid hemangioblastoma.Methods The data of 16 patients with posterior fossa solid hemangioblastoma treated by navigation-assited microsurgery were analyzed retrospectively,compared with 19 patiems treated by microsurgery who suffered the same disease in the similar location(control group).Results The tumors were totally resected successfully acompanied by minimal blood loss and shortening of the operation time,compared with the control group.Manipulation and removal of these tumors were actually easier,in addition,adjacent structures can avoid damage.Conclusions Navigation-assited microsurgery is useful technique to surgical resection of fossa solid hemangioblastoma by significantly reducing blood loss at the time of surgery and operation procedure time,avoiding damage to the adjacent structures,and reducing the surgery complications and mortality.

Objective To investigate the role and existing dilemmas of policies related to traditional Chinese medicine talents in China in terms of their growth paths and attitudes towards existing policies.Methods A questionnaire survey was conducted to investigate the current situation of the development of traditional Chinese medicine talents and their views on the existing policies.Results 278 valid questionnaires were collected.In general,traditional Chinese medicine talents are quite satisfied with the current talent policy,the interviewees with senior professional titles have a better understanding of the talent policy,and the young members and members of the Chinese society of traditional Chinese medicine have a more positive and urgent attitude towards building a talent policy and evaluation index system with traditional Chinese medicine characteristics.Respondents generally believe that the current financial support for talent projects of traditional Chinese medicine is average,but it can stimulate the growth of young scholars.The title of talents and the achievements of scholars'scientific research complement each other.Conclusion In the process of the development of the field of traditional Chinese medicine,we should speed up the training of innovative talents of traditional Chinese medicine,establish talent evaluation indicators with traditional Chinese medicine characteristics,improve the evaluation and project management system of traditional Chinese medicine talents,and reasonably optimize the incentive mechanism brought by the title of talents.

Objective:To compare the effectiveness of awake prone positioning (APP) care combined with standardized nursing and standardized nursing care in the prevention of early postoperative pulmonary complications (PPCs) in elderly patients with hip fracture.Methods:A retrospective cohort study was conducted to analyze the clinical data of 84 elderly patients with hip fracture Admitted to Zhongda Hospital Affiliated to Southeast University from February 2021 to August 2021. There were 31 males and 53 females, aged 67-96 years [(82.3±6.3)years]. Fracture types were femoral neck fracture ( n=45) and intertrochanteric fracture ( n=39). Surgical procedures included closed reduction internal fixation ( n=39), hip hemiarthroplasty ( n=35), and total hip arthroplasty ( n=10). Among them, 42 patients received standardized nursing care and APP intervention (APP combined with standardized nursing care group), while the remaining 42 patients received standardized nursing care only (standardized nursing care group). The incidence rate of PPCs (including pneumonia, respiratory failure, pleural effusion, atelectasis and pulmonary edema) within 30 postoperative days, arterial oxygen pressure (PaO 2), arterial carbon dioxide pressure (PaCO 2), arterial oxygen saturation (SaO 2) on the 4th postoperative day, difference in PaO 2 between the 4th postoperative day and emergency visit, clinical pulmonary infection score (CPIS) on the 4th postoperative day, and number of adverse events related to APP were compared between the two groups. Results:All the patients were followed up for 30-90 days [(86.1±16.5)days]. The incidence rates of PPCs and type 1 postoperative respiratory failure in the APP combined with standardized nursing care group were 16.7% (7/42) and 4.8% (2/42), and were 35.7% (15/42) and 21.4% (9/42) in the standardized nursing care group (all P<0.05). The PaO 2 and SaO 2 on the 4th postoperative day, and difference in PaO 2 between the 4th postoperative day and emergency visit were (82.0±8.8)mmHg, 0.96±0.01, and 3.2 (-1.9, 8.0)mmHg in the APP combined with standardized nursing care group, and were (74.3±12.1)mmHg, 0.94±0.03, and -7.6 (-17.2, 1.1)mmHg in the standardized nursing care group (all P<0.01). The CPIS on the 4th postoperative day was 2.0 (1.0, 3.0)points in the APP combined with standardized nursing care group and 4.0 (1.0, 7.0)points in the standardized nursing care group ( P<0.05). No statistically significant differences were observed in the incidence of pneumonia, type I respiratory failure, pleural effusion, atelectasis and pulmonary edema within 30 postoperative days, as well as PaCO 2 on the 4th postoperative day between the two groups (all P>0.05). None of the patients experienced adverse events related to APP. Conclusion:For elderly patients with hip fracture, compared with standardized nursing care, application of APP combined with standardized nursing care can significantly decrease the incidence rate of early PPCs, especially type I respiratory failure, and improve postoperative oxygenation.

Objective:To analyze the risk factors for postoperative one-year mortality in elderly patients with femoral intertrochanteric fracture following multidisciplinary treatment (MDT) by intramedullary nailing.Methods:The clinical data were retrospectively analyzed of the 158 elderly patients with femoral intertrochanteric fracture who had undergone MDT by proximal femoral intramedullary nailing between January 2018 and August 2020 at Department of Orthopedics, Trauma Center, Zhongda Hospital Affiliated to Southeast University. There were 41 males and 117 females with an average age of 82.5 years (from 65 to 95 years). By the modified Evans classification, there were 15 cases of type Ⅰ, 16 cases of type Ⅱ, 35 cases of type Ⅲ, 81 cases of type Ⅳ, and 11 cases of type Ⅴ. The one-year mortality was documented in the patients after surgery. To screen for risk factors, univariate analysis was conducted of gender, age, body mass index (BMI), modified Evans classification of fractures, time from injury to operation, American Society of Anesthesiologists (ASA) classification, Charlson comorbidity index (CCI) and comorbidities, as well as preoperative hemoglobin (Hb), serum albumin (ALB) and total lymphocyte count (TLC). The factors with P<0.05 were included in the multivariate logistic regression model analysis to determine the risk factors. Results:A total of 13 patients died within one year after surgery, yielding a mortality of 8.2% (13/158). Univariate analysis showed significant differences in age, body mass index, modified Evans classification of fractures, CCI and Hb between the surviving and dead patients ( P<0.05). Multivariate logistic regression analysis showed that age >85 years ( OR=0.122, 95% CI: 0.018 to 0.834, P=0.032), BMI>23.9 kg/m 2 ( OR=0.083, 95% CI: 0.013 to 0.510, P=0.007), CCI≥3 points ( OR=0.051, 95% CI: 0.090 to 0.275, P=0.001) and preoperative Hb<90 g/L ( OR=4.733, 95% CI: 1.036 to 21.624, P=0.045) were the independent risk factors for postoperative one-year mortality in the elderly patients with intertrochanteric fracture following MDT by proximal femoral intramedullary nailing. Conclusions:After MDT by proximal femoral intramedullary nailing of femoral intertrochanteric fractures, the geriatric patients with an age >85 years, BMI>23.9 kg/m 2, CCI≥3 points and Hb<90 g/L are likely to die. Therefore, special care should be taken for them.

Objective:To analyze the characteristics and risk factors of previous low-energy fractures in elderly patients with hip fractures admitted to our hospital.Methods:The data for this study was collected from 596 hip fracture patients admitted to Zhongda Hospital Affiliated to Southeast University between January 2018 and December 2021.Out of these patients, there were 404 females and 192 males.Based on the history of low-energy fracture before hip fracture, the patients were divided into two groups: a low-energy fracture group and a non-low-energy fracture group.A comparison was made between the two groups in terms of gender, age, fracture type, BMI, number of combined medical diseases, ASA score, and other characteristics.Results:The study included a total of 596 patients, with 368 patients having no history of low-energy fractures and 228 patients with low-energy fractures.Among the patients with low-energy fractures, there were 118 vertebral fractures, 69 hip fractures, 57 rib fractures, 19 radial fractures, 14 humerus fractures, and 12 patella fractures.Univariate analysis revealed significant differences in age, gender, fracture type, number of combined medical diseases, and ASA score between the two groups( P<0.05 for all). The results of multivariate Logistic analysis indicated that age( OR=1.046, 95% CI: 1.022-1.070), female sex( OR=1.474, 95% CI: 1.011-2.148), and the number of comorbid medical diseases( OR=1.211, 95% CI: 1.113-1.318)were independent risk factors for patients with a history of low-energy fractures. Conclusions:Our findings provide evidence that vertebral, hip, and rib fractures were the three most common previous low-energy fractures in elderly patients with hip fractures.We identified age, female gender, and number of medical diseases as independent risk factors for prior low-energy fractures in this population.