BACKGROUND: Senile intertrochanteric fracture is characterized as aging, instability, more complications and high mortality, so choosing an appropriate internal fixation method is critical.OBJECTIVE: To compare the curative efficacy of proximal femoral nail anti-rotation and locking proximal femoral plate for senile osteoporotic patients with unstable intertrochanteric fractures.METHODS: Sixty elderly patients with unstable intertrochanteric fractures were enrolled, and the clinical data were collected. They were randomized into treatment and control groups (n=30 per group), and subjected to internal fixation using proximal femoral nail anti-rotation and locking proximal femoral plate, respectively. The operative indexes,functional recovery and complications were observed in the two groups RESULTS AND CONCLUSION: (1) The incision length, operation time, intraoperative blood loss and time of weight bearing in the treatment group were significantly less than those in the control group (P < 0.01). (2) Harris hip scores in the treatment group were significantly higher than those in the control group (P < 0.05). (3) The incidence of complications in the treatment group was obviously lower than that in the control group. (4) To conclude, the proximal femoral nail anti-rotation exhibits satisfactory treatment outcomes in the internal fixation of unstable intertrochanteric fractures.

Objective: To evaluate the outcomes of splenectomy in the treatment of relapsed/refractory autoimmune hemolytic anemia (AIHA). Methods: Retrospective analysis was performed in 30 cases with relapsed/refractory AIHA who were treated with splenectomy in our hospital. The pre- and post-operative blood routine indexes and responses were followed up. Results: Among the 30 relapsed/refractory AIHA patients, 20 were pure AIHA (including 13 patients with warm antibody AIHA, 2 with warm-cold double antibody AIHA and 5 with Coombs negative AIHA) and 10 were Evans syndrome. The short-term response was evaluated 10-14 days after operation, and the overall response rate (ORR) of short-term response was 90% [12 cases in complete response (CR), 6 cases in partial response (PR)] in 20 therapeutic evaluable cases. Among 13 patients with long-term follow-up data, except 3 patients with Evans syndrome died (2 cases were refractory to splenectomy, 1 case relapsed after surgery), the ORR of 10 patients with relapsed/refractory pure AIHA at 6 months and 12 months were 90% (9/10) and 70% (7/10), respectively, with a median follow-up of 14 (4-156) months. At the end of follow-up, 3 cases had maintained CR for more than 3 years. Conclusion The short-term response of splenectomy as a second-line treatment for relapsed/refractory AIHA is satisfactory, and long-term outcome of splenectomy is up to 70% at 1 year. Approximately one-third of patients could maintain sustained remission.

Objective:To investigate the diagnostic value of transvaginal four-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy) in assessing tubal patency in patients with infertility.Methods:A total of 160 patients with infertility diagnosed at Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Zhejiang Chinese Medical University, from June 2019 to June 2022 were retrospectively included in this study. All patients underwent 4D-HyCoSy examinations. The results of hydrotubation were used as the gold standard to evaluate the diagnostic efficacy of 4D-HyCoSy for assessing tubal patency in patients with infertility. The differences in the pelvic dispersion of the contrast agent and the surrounding conditions of the ovaries were evaluated across varying degrees of tubal patency. Any adverse reactions experienced by patients during the 4D-HyCoSy examination were recorded.Results:The diagnostic agreement rates of 4D-HyCoSy for assessing tubal patency, partial patency, and obstruction in patients with infertility were 90.07% (127/141), 92.10% (105/114), and 93.85% (61/65), respectively. The sensitivity, specificity, and accuracy of 4D-HyCoSy examination for diagnosing tubal patency in patients with infertility were 93.85% (61/65), 99.22% (253/255), and 98.12% (314/320), respectively. Statistically significant differences were observed in the pelvic dispersion of the contrast agent and the surrounding conditions of the ovaries across varying degrees of tubal patency (χ2 = 411.58, 286.32, both P < 0.001). The incidence of mild pain during the 4D-HyCoSy examination was 18.12% (29/160), with no other adverse reactions reported. Conclusion:4D-HyCoSy has a low incidence of adverse reactions and high safety. Its diagnostic results show a high level of consistency with hydrotubation results, making it an effective method for assessing and diagnosing tubal patency in patients with infertility.