1.Risk factors of perioperative heart failure in elderly patients with femoral neck fracture after hip joint replacement
Rixu JI ; Zuoxi CHEN ; Yinsheng WU ; Huanxing LIU ; Chongqing LI
Chinese Journal of Trauma 2018;34(11):1030-1034
Objective To investigate the risk factors of perioperative heart failure in the elderly patients with femoral neck fracture treated with hip joint replacement so as to provide relevant clinical reference.Methods A retrospective case control study was conducted to analyze the clinical data of 155 elderly patients with femoral neck fractures who underwent total hip or hemiarthroplasty in Wenzhou Traditional Chinese and Western Medicine Hospital from May 2012 to August 2016.There were 62 males and 93 females,aged (75.6 ± 7.4)years.The patients were divided into heart failure group (26 patients)and non heart failure group (129 patients).Heart failure group included 10 males and 16 females,aged (78.3 ± 8.2)years.There were 52 males and 77 females in the non heart failure group,aged (74.5 ±6.7) years.Information including age,gender,history of hypertension,history of heart diseases,American Society of Anesthesiologists (ASA) physical status classification,duration from injury to surgery,preoperative renal function,perioperative fluid balance,operation method,operation time,postoperative pain score,perioperative blood loss,and constipation were collected.Univariate analysis was firstly performed on the above data,and multivariate logistic regression analysis was conducted on the significant factors generated by the univariate analysis so as to identify independent risk factors for perioperative heart failure.Results According to the univariate analysis,age,history of heart diseases,preoperative renal function,and perioperative fluid balance were statistically different between the two groups (P < 0.05).Multivariate analysis results showed that the independent risk factors of perioperative heart failure included age (OR =5.351,95% CI 1.459-19.623,P < 0.01),history of heart diseases (OR =5.717,95 % CI 2.399-13.624,P < 0.01),preoperative renal function (OR =2.670,95% CI 1.125-6.336,P < 0.05),perioperative fluid balance (OR =2.980,95% CI 1.287-6.899,P <0.01).Conclusions Age,history of heart diseases,preoperative renal function,and perioperative fluid balance are the risk factors of perioperative heart failure in elderly patients with femoral neck fracture.Therefore,more attention should be paid to these risk factors and corresponding preventative measures should be taken to reduce the incidence of perioperative heart failure.
2.Effect analysis of posterolateral combined with posteromedial approach in patients with posterior Pilon fracture
Jia SU ; Xinsheng SHEN ; Rixu JI
Chinese Journal of Postgraduates of Medicine 2018;41(9):826-829
Objective To explore the effect of posterolateral combined with posteromedial approach in patients with posterior Pilon fracture. Methods The clinical data of 16 posterior Pilon fracture patients who had underwent posterolateral combined with posteromedial approach treatment from June 2014 to December 2016 were retrospectively analyzed. Results The patients were followed up for 12 to 18 months (average 14 months). There were no complications of incision infection, skin necrosis and nerve damage. All the fractures were healed. The fracture healing time was 12 to 24 weeks (average 16 weeks), and no loosening or breakage of the implant was observed. Claw toes deformity occurred in 1 case 6 months after surgery, and the symptom improved after tendon lengthening surgery. According to American Orthopedic Foot and Ankle Society (AOFAS) scoring system, the results of ankle function were excellent in 8 cases, good in 5 cases, and fair in 3 cases. Conclusions The posterolateral combined with posteromedial approach for treatment of posterior Pilon fracture can achieve satisfactory clinic effects because it has many advantages such as good exposure, easy reduction and fixation, less invasion of soft tissue and so on.
3. Salvianolic acid B promotes the survival of abdominal island flap after ischemia-reperfusion injury in rats
Huanxing LIU ; Rixu JI ; Xinsheng SHEN ; Zuoxi CHEN ; Chongqing LI
Chinese Journal of Microsurgery 2019;42(6):557-561
Objective:
To explore the therapeutic effect of salvianolic acid B (Sal B) on rat abdominal island flap after ischemia-reperfusion injury, and to explore the related mechanisms.
Methods:
Fifty-four male Sprague-Dawley rats were randomly divided into 3 groups and rat lower abdomen island flap models were established: ①Sham-operated group (Sham group): non-blocking blood vessels, intraperitoneal injection of equal volume of saline as Sal B group; ②Model group: blocking blood vessels for 8 h, intraperitoneal injection of the same volume of saline as Sal B group; ③salvianolic acid B group (Sal B group): blocking blood vessels for 8 h, intraperitoneal injection of 40 mg/Kg of Sal B per day. Seven days after continuous drug administration, the survival rate of the flaps in each group was evaluated, and then the animals from each group were sacrificed for the specimens which were used for the following tests: HE staining was performed to evaluate the microvessel density (MVD), and immunohistochemistry was used to detect the level of vascular endothelial growth factor (VEGF) and superoxide dismutase 1 (SOD1). The contents of superoxide dismutase SOD and malondialdehyde (MDA) in flap tissue were tested using the corresponding kit.
Results:
Seven days after flap operation, the survival rate of Sal B group flap[(65.62±13.20)%] was significantly higher than that of the model group, while HE staining showed an increase in MVD in Sal B group [(28.27±3.19)/mm2 and (15.79±6.12)/mm2, respectively]. The differences were statistically significant (