Objective To compare the clinical outcomes of unstable femoral trochanteric fracture treated by proximal femoral intramedullary nail enhanced with lateral locking plate versus cerclage steel wire. Methods A retrospective study was conducted on 83 patients who received open reduction and internal fixation with proximal femoral intramedullary nail combined with lateral enhanced fixations for unstable femoral trochanteric fractures from March 2015 to January 2017 in our hospital. Of these patients, 39 received the lateral enhanced fixation with locking plate, while the remaining 44 had cerclage wire as additional fixation. The clinical data were compared between the two groups. Results All the patients in the study had surgical procedures performed smoothly. Although the plate group had significantly longer operation times and significantly higher hospitalization expenses than the wire group (P < 0.05), no statistically significant differences in intraoperative blood loss and hospital stay were proved between the groups (P > 0.05). The follow‐up period lasted for 12–24 months with an average of (16.81 ± 2.92) months. The plate group returned to full‐weight bearing significantly earlier than the wire group (P < 0.05). The Harris Hip Score (HHS) significantly increased in both groups over time postoperatively (P < 0.05). The plate group achieved a higher HHS than the wire group, which was statistically significant at 3 months (P < 0.05), whereas it became insignificant at 6 and 12 months postoperatively (P > 0.05). Regarding radiographic assessment, an excellent rate of fracture reduction was proved in 71.79% of the plate group, compared to 45.45% of the wire group, which was statistically significant (P < 0.05). In addition, fracture healing was achieved significantly earlier in the plate group than the wire group (P < 0.05); nevertheless, no statistically significant difference was noted in neck‐shaft angle at the latest follow‐up between the two groups (P > 0.05). At the latest follow‐up, two cases of implant loosening and two cases of coxa varus were found in the plate group, while one case of femoral head necrosis and three cases of coxa varus were revealed by radiographs in the wire group. Conclusion The cerclage wire has benefits of saving time and operation costs; however, the locking plate has the advantages of improving fracture reduction quality, shortening time to full weight bearing and fracture healing, and improving hip function recovery due to the lateral additional fixations to proximal femoral intramedullary nail for unstable trochanteric fractures.

To investigate the influencing factors of fracture nonunion after intramedullary nailing for subtrochanteric fractures and to construct a risk assessment model. Based on the multicenter retrospective analysis of 251 patients, all patients were divided into modeling group and verification group. In the modeling group, postoperative fracture nonunion rate, general data, fracture-related factors, surgical reduction-related factors, mechanical and biological factors were calculated, and the influencing factors of fracture nonunion were screened by univariate analysis. Logistic regression model was used for multifactor analysis to construct the risk assessment model. Based on the logistic regression model, the risk prediction model was constructed by drawing the Nomogram diagram. Through the verification group, the influencing factors were evaluated again, and the differentiation and calibration of the model were evaluated. The calibration degree was evaluated by Hosmer-Lemeshow test, goodness of fit test, and calibration curve. The discriminant degree was evaluated by the receiver operating characteristic curve. Fracture nonunion occurred in 34 of 149 patients in the modeling group. Among the 14 potential influencing factors, univariate analysis and logistic regression analysis showed that postoperative hip varus, intramedullary nail fixation failure, and reduction of fracture with large incision were the risk factors of fracture nonunion. The medial cortex fracture was seen reduced on X-Ray was a protective factor for fracture nonunion, and a regression equation was established. Based on the logistic regression model, the Nomogram diagram is drawn. Twenty-four cases of fracture nonunion occurred in the verification group. The area under the receiver operating characteristic curve was area under curve =0.883 > 0.7, indicating that there was a moderate differentiation to evaluate the occurrence of fracture nonunion after operation. The goodness of fit test: the Hosmers-Lemeshow test ( X 2 = 2.921, P = .712 > .05) showed that the model had a good calibration. After intramedullary nailing of subtrochanteric fracture, hip varus, failure of intramedullary nail fixation and wide surgical dissection are the risk factors of fracture nonunion, and the postoperative reduction of medial cortex fracture is protective factor. National key research and development projects: 2016YFC0105806

A new direct procedure for the determination of inorganic arsenic species was developed by electrochemical hydride generation atomic absorption spectrometry (EcHG-AAS) with selective electrochemical reduction. The determination of inorganic arsenic species is based on the fact that As(III) shows significantly higher absorbance at low electrolytic currents than As(V) in 0.3 mol•L −1 H 2 SO 4 . The electrolytic current used for the determination of As(III) without considerable interferences of As(V) was 0.4 A, whereas the current for the determination of As(III) and As(V) was 1.2 A. For equal concentrations of As(III) and As(V) in a sample, the interferences of As(V) during the As(III) determination were smaller than 5%. The absorbance for As(V) could be calculated by subtracting that for As(III) measured at 0.4 A from the total absorbance for As(III) and As(V) measured at 1.2 A, and then the concentration of As(V) can be obtained by its calibration curve at 1.2 A. The methodology developed provided the detection limits of 0.3 and 0.6 ng•mL −1 for As(III) and As(V), respectively. The relative standard deviations were of 3.5% for 20 ng•mL −1 As(III) and 3.2% for 20 ng•mL −1 As(V). The method was successfully applied to determination of soluble inorganic arsenic species in Chinese medicine.

Modelling based on multi-agent system (MAS) was built for the current production management and process of Shenyang Songyang Paper Cup Co., Ltd. It can transmit the information instantly via order agent (OA), manager agent (MA), production agent (PA), and service agent (SA), and realize information sharing. The PA is also built on MAS, and it includes two agents, task agent (TA), and resource agent (RA). It has been found that the modelling is superior to the old one. It can improve the working flow and production efficiency, and shorten the time of delivery.