Objective To summarize and analyze the failure reason of internal fixation operation in peritrochanteric fractures and propose appropriate prevention measures.Methods The clinical data of 229 patients with peritrochanteric fractures were retrospectively analyzed,the failure reason of internal fixation was analyzed by the univariate and multivariate Logistic regression analysis.Results The univariate analysis showed that the patients' age,gender composition,types of internal fixation had no significantly correlated with the failure of internal fixation (P ＞ 0.05) ; the Garden reset index,bone quality,fracture type and load time had significantly correlated with the failure of internal fixation (P ＜ 0.05).The multivariate Logistic analysis showed that load time was the independent risk factors for fixation failure (OR =13.515).Conclusion The weight-bearing time points should be selected according to the bone quality,fracture type,and degree of intraoperative reset,thereby reducing the risk of surgery failure.

Objective    To compare the feasibility and safety of video-assisted thoracoscopic surgery (VATS) under non-intubated, intravenous anesthesia with spontaneous ventilation. Methods    A total of 80 patients undergoing VATS (48 wedge resections, 8 sympathectomies, 24 pleural biopsies) between January 2015 and June 2017 were included. Those patients were randomized into two groups. The 40 patients were enrolled as a treatment group (19 males and 21 females at age of 23.3±10.2 years) and received surgery under non-intubated intravenous anesthesia with spontaneous ventilation. And the other 40 patients were enrolled as a control group (21 males and 19 females at age of 22.2±9.9 years) and received surgery under routine intravenous anesthesia with intubated ventilation. Results    Comparing with the control group, the patients of the treatment group had lower white blood cell count (5.8×109±2.4×109 vs. 7.3×109±3.6×109, P<0.001), lower gastrointestinal adverse reaction rate (7.5% vs. 27.5%, P=0.002), lower sore throat rate (5.0% vs. 30.0%, P<0.001), lower cough grade (0.9±0.3 vs 2.1±0.5, P<0.050), shorter drainage time (1.8±1.6 d vs. 3.7±1.8 d, P<0.050) and shorter hospital stay (2.3±1.8 d vs. 5.8±2.3 d, P<0.050). Conclusion    Video-assisted thoracoscopic surgery under non-intubated, intravenous anesthesia with spontaneous ventilation is safe and feasible, which also has certain advantages in reducing the postoperative complications and promoting patients' quick recovery from surgery.