随着近年来医学技术的发展,例如关节置换技术的成熟使得下肢骨关节炎和股骨颈头下型骨折患者生活质量得到了质的改善.以及一些骨科大手术技术的成熟使得越来越多的疾病通过手术治疗可以基本或者完全恢复原来的功能.但是,下肢深静脉血栓的高发生率一直以来都是困扰临床治疗的一大难题.对于如何更好的预防、尽早发现和尽早治疗骨科大手术患者下肢深静脉血栓这一问题成了近来研究的热点.接下来,本文就近年来国内外关于骨科大手术围术期下肢深静脉血栓诊疗进展做一综述,以便大家共同学习.

目的 研究秦皮等10种中药在体外对白色念珠菌浮游菌和生物膜的抑制作用.方法 10种中药为秦皮、高良姜、地肤子、黄连、白头翁、土槿皮、白蔹、栀子、大黄、鱼腥草,分别用水煎煮浓缩为1 g/L.XTT减低法检测10种中药对抑制白色念珠菌50％生物膜(SMIC50)的浓度,血清芽管试验.结果 黄连、秦皮和土槿皮对白色念珠菌芽管的抑制较为明显,黄连SMIC50为31.25mg/L,秦皮和土槿皮均为62.5 mg/L,地肤子、白头翁等在500 mg/L时仍未见抑菌效果.结论 黄连、秦皮和土槿皮对白色念珠菌生物膜具有明显抑菌效果,地肤子、白头翁的抑菌效果不太明显.

Objective To compare the clinical efficacy of open reduction and internal fixation with or without bone graft treatment for displaced intra-articular calcaneal fractures.Methods The following electronic database was searched:PubMed,Embase and Conchrane Libray database.The time limit was from the establishing of the database to April 2017.Main evaluation index included excellent rate of foot function,Bohler angle,Gissane angle,calcaneus height,SF-36.Secondary evaluation index included incision necrosis or dehiscence,wound infection and osteoarthritis.The Review Manager 5.3 software was used for Meta-analysis.Results There were seven articles in qualitative and quantitative synthesis,two groups of a total of 824 cases,399 cases of bone graft.The Meta analysis showed that bone graft group and non bone graft group were not statistically significantly different at the end of follow-up (excellent rate of foot function,Bohler angle,Gissane angle,calcaneus height,incision necrosis or dehiscence,wound infection and osteoarthritis).There was statistically significant difference in SF-36.Conclusion According to meta analysis results,considering bone grafts leading to higher hospital costs or pain in donor site after autologous bone graft,bone graft is not essential for displaced intra-articular calcaneus fractures.