目的 分析老年髋部骨折患者术后感染的因素及采取的预防与控制措施.方法 选取我院2019年1月至2020年6月间收治的120例老年髋部骨折患者为研究对象,分为两组各60例.对照组实施常规干预路径;实验组实施围手术期感染干预路径,分析患者术后感染的高危因素及感染率,评比两组患者围手术期相关指标.结果 两组患者术后感染与患者的年龄有关系(P＜0.05);两组患者住院时间、感染防护知识掌握情况,实验组优于对照组(P＜0.05).结论 老年髋部骨折患者术后感染的因素主要是年龄,将围手术期感染干预路径应用在老年髋部骨折的患者中,能降低术后感染,值得推广.

目的:调查海军陆战队某部寒区机动演练中的冻伤发病情况,为指导部队做好防冻伤工作提供依据.方法:按照冻伤诊断标准,以纳入的381例冻伤病例为研究对象,采集其基本信息、冻伤部位、岗位信息、文化程度、生活习惯、既往冻疮史等资料,统计各自构成比,研究冻伤发病可能的相关因素.结果:381例中,冻伤部位主要为头面耳部和四肢,冻伤分级均为Ⅰ度或Ⅱ度.各个岗位、职别、文化程度,冻伤均有发生.有冷习服训练与每天更换袜子与鞋垫的冻伤构成比,分别显著低于无冷习服训练和不能每天更换者(P＜0.05).既往有冻疮史的官兵,其冻伤构成比显著高于无冻疮史的官兵(P＜0.05).结论:冻伤是寒区的常见训练伤.长时间从事精细作业、既往有冻疮史是冻伤的易感人群.加强防冻伤意识、培养良好的生活习惯和进行冷习服训练,可减少冻伤发病.

目的 比索洛尔是一种高选择性β1受体阻滞剂药物,具有降低交感神经活性、减慢心率、降压等作用.观察比索洛尔对小鼠心肌微血管内皮细胞缺氧复氧损伤的保护作用及探讨机制.方法 选取8周龄雄性C57BL/6N小鼠,分离并培养左心室心肌微血管内皮细胞(CMECs).按实验方案,将CMECs分组:正常组(CMECs予正常培养)、溶剂对照组(CMECs予比索洛尔培养24 h,终浓度为2μmol/L)、缺氧复氧组(CMECs进行缺氧4 h,然后复氧2h)、比索洛尔组(CMECs予比索洛尔培养24 h后,终浓度为2μmol/L,进行缺氧4h,复氧2h处理).分别检测各组细胞增殖能力、细胞凋亡水平、细胞内超氧阴离子水平及蛋白Cleaved caspase-3、Nox2水平.结果 与正常组比较,缺氧复氧组CMECs凋亡数增加[(4.76±1.15)％vs(20.2±2.59％)],差异有统计学意义(P<0.05);与缺氧复氧组比较,比索洛尔组CMECs凋亡数[(15.7±2.73)％]降低(P<0.05)..与正常组比较,缺氧复氧组CMECs增殖能力降低、细胞内超氧阴离子水平升高、Cleaved caspase-3及Nox2表达升高,差异有统计学意义(P<0.05);与缺氧复氧组比较,比索洛尔组CMECs增殖能力升高、细胞内超氧阴离子水平降低、Cleaved caspase-3及Nox2表达下降,差异有统计学意义(P<0.05).结论 比索洛尔通过降低Nox2表达水平,减少细胞内ROS水平起到保护CMECs缺氧复氧损伤的作用.

目的 探究分析不同手术方式对下胫腓联合分离踝关节损伤的临床治疗效果.方法 选取2017年11月至2019年11月在我院进行手术治疗的下胫腓联合分离踝关节损伤患者共100例,采取随机分组方式将所有患者均分为两组,观察组和对照组各50例,观察组患者采用骨膜移位术,对照组患者给予短肌腱移位手术治疗.对比患者手术时间、住院时间以及骨愈合时间,对比临床治疗效果.结果 对比疗效,观察组总有效率明显高于对照组(P<0.05);对比时间,观察组康复用时明显短于对照组(P<0.05),存在统计学意义.结论 对下胫腓联合分离踝关节损伤患者行骨膜移位术,手术效率高,术后患者恢复时间较短,安全性高.

军事训练伤,简称“训练伤”,是指军事训练直接引起的组织器官功能障碍或病理改变.据统计,我军的训练伤发生率为15.0％～18.7％[1],训练伤的常见类型为骨和关节损伤、软组织损伤与脏器损伤[2].目前,大强度训练在部队中已呈常态化,训练与伤病矛盾突显.训练伤影响官兵的身心健康,严重的甚至致残和减员.因此,训练伤已成为阻碍战斗力进一步提升的重要因素之一,是我军卫勤保障的重要课题.中医药因其经济有效、简单易行等优点,在防治训练伤中被广泛运用.笔者对中医药防治训练伤的应用研究进展进行综述.

目的 调查了解某部肱骨干投弹骨折的发生率,探讨肱骨干投弹骨折的易感因素,分析致伤原因,并提出合理预防措施.方法 采用回顾性调查方法,对2010-2012年度某部肱骨干投弹骨折发生情况进行调查分析.结果 某部军事训练致肱骨干投弹骨折的发生率1.65‰.步兵骨折发生率明显高于装甲兵、炮兵(P＜0.05);伤者中入伍1年内新兵肱骨干投弹骨折发生率明显高于1～2年军龄及≥2年军龄组(P＜0.05).结论 肱骨干投弹骨折是多方面因素综合作川导致的,错误的投掷动作是造成肱骨干投掷骨折的主要原因,应采取相应预防措施.

Objective To investigate serum leptin and adiponectin levels and their relationship in elderly coronary artery disease (CAD).Methods A total of 88 subjects aged 55 yeas or older were enrolled in which coronary angiograms were performed.The subjects were divided into CAD group (52 patients) and control group (36 patients) by angiography.Serum concentrations of leptin and adiponectin were evaluated by ELISA system.Results Serum concentrations of leptin were significantly increased in CAD group compared with that in control group [(9.38 ±3.51) μg/L vs.(7.27 ±3.25) μg/L,P ＜0.05].On the contrary,serum concentrations of adiponectin were significantly decreased in CAD group compared with that in control group [(11.08 ±3.87) mg/L vs.(13.34 ±4.94) mg/L,P＜0.05].Logistic regression analysis revealed that only serum leptin was the independent risk factor for CAD.Serum adiponectin concentrations had a negative relationship with leptin concentrations (r =-0.320,P =0.002).Conclusion Lower serum adiponectin levels are related to higher serum leptin concentrations.Elevated serum leptin but not decreased serum adiponectin is the independent risk factor for CAD.

Objective To evaluate the clinical effect of throwing fracture of the humeral shaft treated with minimally invasive internal fixation.Methods From February 2006 to July 2012,76 cases of throwing fracture of the humeral shaft were treated with limited open reduction and minim ally invasive internal fixation with screws and wire.All cases were males,with mean age of 20.1 years(17～27 years),involving 70 right arms and 6 left arms. Results 69 patients were followed up from 6 to 23 months,with an average time of 11 months.Bone union was achieved in all cases.According to C assebaum functional grading system,the excellent,good cases were 66 and 3,the excellent and good rate was 100%.Conclusion Limited open redu ction and minimally invasive internal fixation with screws and wire is an effect ive method to treat throwing fracture of the humeral shaft.It has the advantage of simplicity of opration,small wound,low cost and satisfactory functional rec overy.

To promote the continuous development of the small and medium hospitals,the characteristics disciplines should be pay more attention.The measures to advance the discipline development are that strengthening the connotation construction,strengthening the characteristics,developing the hospital guided by the characteristics discipline demands.