Objective:To investigate the effect of biological long stem hemiarthroplasty on postoperative hip joint function, serum bone markers, angiotensin Ⅱ (Ang Ⅱ) and cortisol (Cor) levels in elderly patients with intertrochanteric fractures.Methods:A total of 120 elderly patients with intertrochanteric fractures in General Hospital of Northern Anhui Coal and Power Group from June 2017 to June 2019 were selected. According to the principle of non-randomized clinical concurrent controlled study and patient′s voluntariness, they were divided into arthroplasty group and internal fixation group, with 60 cases in each group. Proximal femoral nail antirotation (PFNA) was used in the internal fixation group, and the biological long stem hemiarthroplasty was performed in the arthroplasty group. The related indexes of perioperative operation and complications, the levels of serum AngⅡ and Cor before and after operation, the levels of serum bone markers osteocalcin (OC), calcitonin (CT), alkaline phosphatase (ALP) before and after operation were compared between the two groups. After followed up for 6 months after the operation, Harris hip function score and Barthel index (BI) score, quality of life score (GQOL-74) before and after operation, and the excellent and good rate of hip joint function at 6 months after operation were compared between the two groups.Results:The time of getting out of bed in the arthroplasty group was shorter than that in the internal fixation group, the operation time was longer than that in the internal fixation group, and the amount of blood loss and postoperative drainage were higher than those in the internal fixation group, and the differences were statistically significant ( P<0.05). The postoperative complication rate in the arthroplasty group was lower than that in the internal fixation group: 8.33%(5/60) vs. 25.00%(15/60), and the difference was statistically significant ( χ2 = 6.000, P<0.05). The levels of serum AngⅡ and Cor in the two groups were higher than those before the operation at the 1st and 3rd day after the operation, but the levels of serum AngⅡ and Cor in the arthroplasty group were also higher than those in the internal fixation group: at the 1st day after the operation: (218.68 ± 42.04) mmol/L vs. (158.19 ± 34.36) mmol/L, (327.15 ± 39.08) μg/L vs. (285.42 ± 34.06) μg/L; at the 3rd day after the operation: (169.46 ± 32.73) mmol/L vs. (138.02 ± 25.97) mmol/L, (294.83 ± 33.95) μg/L vs. (262.64 ± 30.57) μg/L, and the differences were statistically significant ( P<0.05). The levels of serum OC, CT, and ALP in the two groups at 1 month and 3 months after operation were higher than those before the operation, the levels of serum OC, CT, and ALP in the arthroplasty group were higher than those in the internal fixation group: at 1 month after operation: (17.40 ± 4.25) μg/L vs. (14.96 ± 3.79) μg/L, (1.34 ± 0.49) ng/L vs. (1.15 ± 0.43) ng/L, (159.49 ± 19.75) U/L vs. (137.24 ± 17.28) U/L; at 3 months after operation: (19.18 ± 5.79) μg/L vs. (16.24 ± 4.36) μg/L, (1.46 ± 0.57) ng/L vs. (1.24 ± 0.50) ng/L, (180.94 ± 22.42) U/L vs. (163.72 ± 19.36) U/L, and the differences were statistically significant ( P<0.05). TheHarris hip function scores at 1, 3 and 6 months after the operation in the two groups were higher than those before the operation, the Harris hip function scoresin the arthroplasty group were higher than those in the internal fixation group, and the differences were statistically significant ( P<0.05). The excellent and good rate of hip joint function at 6 months after operation in the arthroplasty group was higher than that in the internal fixation group: 90.00%(54/60) vs. 75.00%(45/60), and the difference was statistically significant ( χ2 = 4.675, P<0.05). The scores of BI, GQOL-74 at 1, 3, 6 months after operation in the two groups were higher than those before operation, the scores of BI, GQOL-74 at 1, 3, 6 months after operation in the arthroplasty group were higher than those in the internal fixation group, the differences were statistically significant ( P<0.05). Conclusions:Compared with PFNA internal fixation, the treatment of elderly patients with femoral intertrochanteric fracture with biological long stem hemiarthroplasty can promote the recovery of patients, reduce complications, reduce the impact on bone markers, and more effectively improve the patient′s hip joint function, ability of daily living and quality of life, but it is more traumatic to the body and has a strong stress response.

Objective To study on the relationship between the serum level of highsensitivity c-reaction protein (hs-CR),matrix metalloproteinase 9 (MMT-9),tissue inhibitor of metalloproteinase 1 (TIMP-1) and carotid plaque stability in elderly people.Methods According to the carotid ultrasonography examination,120 old people were divided into vulnerable plaque group (group A,n =45),stable plaque group (group B,n =41) and no plaque group (group C,n =34),and serum levels of hs-CRP,MMP-9,TIMP-1 in each group were also detected.Results The serum levels of hs-CRP and MMP-9 of unstable plaque group and stable plaque group were higher than those of non-plaque group (P ＜ 0.05).hsCRP and MMP-9 were positively correlated with carotid plaque unstability,while TIMP-1 was negatively correlated with carotid plaque unstability,hs-CRP,MMP-9 and TIMP-1 were independent risk factors for carotid plaque stability.Conclusions Serum levels of hs-CRP,MMP-9 and TIMP-1 are closely related to the stability of carotid plaque.Elevated levels of hs-CRP and MMP-9 increase the risk of carotid plaque,and elevated levels of TIMP-1 decrease the risk of carotid plaque.