OBJECTIVETo explore the effectiveness and prognosis on surgical treatment of posterior hip dislocations complicated with fractures of femoral head and acetabulum.

METHODSSeventeen patients with posterior hip dislocations complicated with fractures of femoral head and acetabulum were reviewed in the study. All the patients were treated with manual reduction within 12 hours after injury. CT location was used before operation. Absorbable screw fixation was performed for the femoral head fractures, while plate fixation or resection was performed for acetabular fractures.

RESULTSAll the patients got bony union within 6 months after operation without femoral head necrosis. Evaluate joint function according to Modifie Daobigne and Postal clinical classification criteria, 8 patients got an excellent result, 7 good and 2 fair. The excellent and good rate was 88.2%.

CONCLUSIONSurgical treatment can have a satisfactory prognosis for patient with posterior femoral head and acetabulum.

Acetabulum ; injuries ; Adolescent ; Adult ; Female ; Femoral Fractures ; complications ; Follow-Up Studies ; Hip Dislocation ; complications ; physiopathology ; surgery ; therapy ; Humans ; Male ; Middle Aged ; Treatment Outcome

Objective To observe the nursing of deep venous catheter implantation with two Dacron cuff and to evaluate clinical efficacy.Methods Group A with 20 cases was carried out avul-sion sheath implanted cuffed long-term catheter in right internal jugular vein and group B with 18 cases was implanted long-term catheter by the right external jugular vein incision.The amount of bleeding during the operation,related index of dialysis and catheter -related infection were record-ed.And Kt /V value and catheter dysfunction time were calculated.Results NO catheter -related infection was occurred and bleeding in the group B was less than that in the group A,and there was statistical difference in two groups(P <0.05).Conclusion The operative risk of group B was less than group A and there were no significant differences in dialysis efficacy,catheter dysfunction time and infection rate of two groups after education and nursing.Therefore,both methods could be se-lected in clinic for different patients.

Objective To observe the nursing of deep venous catheter implantation with two Dacron cuff and to evaluate clinical efficacy.Methods Group A with 20 cases was carried out avul-sion sheath implanted cuffed long-term catheter in right internal jugular vein and group B with 18 cases was implanted long-term catheter by the right external jugular vein incision.The amount of bleeding during the operation,related index of dialysis and catheter -related infection were record-ed.And Kt /V value and catheter dysfunction time were calculated.Results NO catheter -related infection was occurred and bleeding in the group B was less than that in the group A,and there was statistical difference in two groups(P <0.05).Conclusion The operative risk of group B was less than group A and there were no significant differences in dialysis efficacy,catheter dysfunction time and infection rate of two groups after education and nursing.Therefore,both methods could be se-lected in clinic for different patients.

OBJECTIVE To analyze the correlation of the peak blood concentration （cmax） of compound sulfamethoxazole （TMP/SMZ） and its metabolite N-acetyl sulfamethoxazole （NSMZ） with clinical efficacy and adverse reactions in critically ill patients. METHODS The data of critically ill patients treated with TMP/SMZ in various ICU of Hainan General Hospital from December 2023 to January 2025 were retrospectively collected. The patients were divided into success group and failure group based on the treatment outcome. Simple linear regression and Spearman correlation analysis were used to analyze the correlation of TMP cmax， SMZ cmax， and NSMZ cmax with clinical efficacy and adverse reactions. The receiver operating characteristic curve （ROC） was used to determine the cutoff values of cmax for predicting the occurrence of adverse reactions. RESULTS Among critically ill patients with an acute physiology and chronic health evaluation Ⅱ （APACHE-Ⅱ） ≥15 points 24 h of check-in at ICU， SMZ cmax of success group was significantly higher than failure group （P＜0.05）. The daily total dose of TMP/SMZ was positively correlated with TMP cmax and SMZ cmax（ P＜0.05）. TMP cmax was significantly correlated with hepatotoxicity and nephrotoxicity， SMZ cmax with hepatotoxicity， and NSMZ cmax with nephrotoxicity （P＜0.05）. The cutoff values of TMP cmax for predicting nephrotoxicity and hepatotoxicity were 7.25 μg/mL and 6.63 μg/mL， respectively. The cutoff value of SMZ cmax for predicting hepatotoxicity was 138.00 μg/mL， and that of NSMZ cmax for predicting nephrotoxicity was 60.76 μg/mL. CONCLUSIONS Among critically ill patients with an APACHE-Ⅱ ≥15 points 24 h of check-in at ICU， SMZ cmax is associated with treatment success. Hepatotoxicity risk significantly increases when TMP cmax ≥6.63 μg/mL or SMZ cmax ≥138.00 μg/mL； nephrotoxicity risk significantly increases when TMP cmax ≥7.25 μg/mL or NSMZ cmax ≥60.76 μg/mL.