Objective To summarize the clinical effects of retrograde intramedullary nail in treating distal femora| fracture. Methods Retrospectively analysed 52 cases of intereondyiar and supracondylar fracture of femur treated with retrograde intrameduUary nail. Results All cases were followed up for 6 to 24 months. All fracture were union except 2 reoperations cases had delay union. Conclusion Retrograde intrameduUary nail has supreme biological stability and allowed early exercise. It also can shorten operation time, reduce damage of periosteum and reduce delay union rate.

Objective To investigate the operative indications and the therapeutic effect of the pedide screw fixation used for treating multiple fractures of the thoracolumbar spine. Methods 16 cases of multiple fractures of the thoracolumbar spine were chosen to be treated by open reduction through posterior approach and pedicle screw fixation. 10 cases were the fractures involved adjacent segments,4 cases were the fractures with one intact vertebral segment between them,2 cases were the fractures with two intact vertebral segments between them. Results The patients were followed up for 12～36 months,with an average of 21.5 months. After the operations,function of moat of the injured nerves had beeu improved or restored. The vertebral height of the fractured segment showed no signifi-cant loss. The materials of internal fixation found no loosening or fracturing at the end of follow-up. Conclusion Fractures of multi-segment of thoraeolumhar vertebrae can cause serious instability and are required for timely treat- ment. The method of the internal fixation with pedicle screw-rod fixation system through posterior approach, fol- lowed by limited decompression, can reconstruct the stability of the vertebrae and promote the recovery of the im- paired neurological functions.

Objective Summarize the clinical experience on the improved intramedullary nail therapy for the fraction of femurand tibia,to improve the skill. Methods The modified intramedullary nail has been used for frac-tion-cure on 64 cases of which 29 are femur fraction and 35 tibin fraction through the period. Results All the pa-tients were recovered within 4 months without any joint malfunction or syndromes. Conclusion The far-end aiming of the modified intrameduUary nail could maintain a 100 % precision, which out down the surgery operation time and reduce bleeding. Remain the advantage of previous intrarnedullary nail is beneficial to bone fraction concrescence and function recovery.

Heart Transplantation ; Humans ; Myocardial Infarction ; Percutaneous Coronary Intervention

As the operation volume in hospitals is increasing year by year, surgical instruments are widely used, which pose a great challenge to the daily management of surgical instruments. The authors investigated the existing problems which occurred in the management of surgical instruments, and came out with instruments coding navigation index and specialized placement scheme for the operating room as solutions. The specific measures included dividing sterile items into specialized categories, setting cabinets respectively for specialized and general subjects, building equipment coding and identification, establishing surgical instruments navigation index and carrying out training program, to serve as reference for efficient and fine management of surgical instruments.

Objective:To explore the value of nursing checklist in posterior surgery for thoracolumbar fracture with general anesthesia under prone position.Methods:A retrospective case series study was conducted to analyze the clinical data of 106 patients with thoracolumbar fracture admitted to Sir Run Run Shaw Hospital，Zhejiang University School of Medicine from June 2018 to May 2020. There were 80 males and 26 females，with age range of 25-57 years［（48.6 ± 11.9）years］. Segments of injury were located at T 11 in 18 patients，at T 12 in 26，at L 1 in 21，at L 2 in 25 and at L 3 in 16. All patients were treated with thoracolumbar posterior screw fixation under general anesthesia. Of all，51 patients received conventional postural nursing from June 2018 to May 2019（control group），and 55 patients received prone position nursing scheme for general anesthesia on the basis of conventional postural nursing from June 2019 to May 2020（verification group）. The incidence of postoperative complications including stress injury，brachial plexus injury，ulnar nerve injury and ocular discomfort as well as length of hospital stay and patients’ satisfaction were compared between the two groups. Visual analogue scale（VAS）and Oswestry disability index（ODI）were also used to measures outcome at postoperative 3 months. Results:All patients were followed up for 8-12 months［（10.5±0.9）months］. Verification group and control group showed significant differences in the incidence of stress injury（4%∶29%），brachial plexus injury（4%∶16%）and ocular discomfort consisiting of tears（2%∶12%），foreign body sensation（0%∶4%）and dryness（4%∶16%）（ P < 0.05），not in ulnar nerve injury and blurred vision. Length of hospitalization in verification group was（7.0±1.3）days，significantly shorter than that in control group［（9.9±1.9）days］（ P < 0.05）. Satisfaction of patients in verification group and control group was 85%（47/55）and 69%（35/51），respectively（ P < 0.05）. At 3 months postoperatively，VAS in verification group［（1.9 ± 0.8）points］was significantly lower than that in control group［（3.5±1.1）points］（ P < 0.05），and ODI was similar between the two groups（ P > 0.05）. Conclusions For patients with thoracolumbar fracture treated by posterior surgery with general anaesthesia under prone position，nursing checklist helps reduce occurrence of the related complication，shorten length of hospital stay，improve patient satisfaction，reduce postoperative pain and promote rehabilitation.