Objective To develop a new scoring system,Daping orthopedics operation risk scoring system for senile patient(DORSSSP),for preoperative evaluation of operative risks in the elderly patients with hip fractures based on acute physiology and chronic health evaluation(APACHE)Ⅱ scoring system and physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM)and compare the new scoring system with APACHE Ⅱ and POSSUM in assessing surgical risks and predicting postoperative complications and mortalities.Methods A total of 260 patients with hip fractures treated in our department in recent five years were retrospectively and respectively evaluated with DORSSSP,POSSUM,progressed POSSUM(P-POSSUM)and APACHE Ⅱ scoring system to compare the value of three scoring systems in preoperative evaluation of operative risks and prediction of postoperative mortality and complications.Results POSSUM and DORSSSP predicted complications in 119 and 92 patients respectively,while the actual complication occurred in 84 patients.The prediction value of POSSUM was significantly higher than the actual value,while the prediction value of DORSSSP showed no statistical difference compared with the actual value.POSSUM,P-POSSUM and APACHEⅡ scoring systems predicted 16,10 and 12 deaths respectively,but there were six deaths in fact,with prediction value obviously higher than the actual value.DORSSSP predicted nine deaths,the closest value to the actual.Conclusions DORSSSP has good correlation with postoperative complications and mortalities.Compared with POSSUM and APACHE Ⅱ scoring system,more simple and practicable DORSSSP can more accurately evaluate the preoperative risks and predict the postoperative complications and mortalities in the elderly patients with hip fractures.

Object To optimize the preparation procedure for WEI'AN GRANULES Methods The optimum conditions of WEI'AN GRANULES were selected with the active components: magnolol, polysacchride of Rhizoma Atractylodis Macrocephalae and berberine hydrochloride as mark by orthogonal test Results The optimum preparative procedure was as follow: Cortex Magnoliae officinalis and Fructus Aurantii Immaturus were extracted with water and precipitated with alcohol (adding 20 fold water as much as medicine, extracting three times, 0 5 h per time and precipitated with 95% alcohol to remove impurities); Rhizoma Coptidis was extracted with 95% alcohol by refluxing; Rhizoma Atracylodis Macrocephalae and other herbs were extracted with water (adding 24 fold water as much as medicine, extracting twice, 2 h per time, its granule size of Rhizorna Afracylodis Macrocephalae was 2 mm to 4 mm) Conclusion The optimum preparative procedure is reliable and the extracting ratio of active component is high

BACKGROUND: Idiopathic scoliosis is a common spinal deformity in teenagers, which is managed mainly by orthomorphia. However, due to great trauma, long operative duration and large blood loss, a great amount of blood transfusion is needed during the surgery. Allogeneic blood transfusion should be reduced in order to release blood insufficient, decline blood transfusion expense, as well as avoid transfusion diseases. OBJECTIVE: To investigate the value of controlled hypotension combined with autotransfusion in idiopathic scoliosis orthomorphia.METHODS: Intraoperative controlled hypotension was performed during posterior orthomorphia surgery on all the 46 cases of idiopathic scoliosis, 17 cases in which were served as the control group, who underwent allogeneic blood transfusion without autotransfusion, while the other 29 cases were served as the experimental group, who underwent autotransfusion that including reinfusion of preoperative deposited autologous blood and intra-operative salvaged autologous blood. The blood loss volume and transfusion status in two groups were observed. RESULTS AND CONCLUSION: Blood loss volume in the control group was 400-1 000 (867±161) mL, and that in the experimental group was 350-1400 (842±376) mL, There was no marked difference between the two groups (P > 0.05). The volume of allogeneic blood transfusion in the control group was 500-1 800 (845±332) mL, which was greater than that in the experimental group [0-1 300(423±237) mL] (P < 0.01). The results suggested that controlled hypotension reduces intraoperative bleeding, and postoperative autotransfusion minimizes the need of allogeneic blood transfusion.

ObjectiveTo discuss the correlation of the surgical risk score with the change of T cell subsets and the occurrence of postoperative complications. MethodsA total of 260 patients with hip fractures treated in our department were enrolled in this study and divided into high-risk group ( Group A) and low-risk group (Group B) based on the surgical risk score. The fasting peripheral venous blood was taken in the morning at one day before surgery and at days 1,3, 5, 7 and 14 after surgery for measuring CD3, CD4 and CD8 levels respectively in two groups.In the meantime, the correlation of level changes with risk score and postoperative complications was observed in two groups. ResultsThere were two patients with lung infection in the Group B, with no death. There were two patients with pulmonary infection, one with wound infection and two with deep vein thrombosis, with one death. The postoperative levels of CD3 and CD4 in the Group A and Group B were significantly lower than those in the control group (P ＜ 0.01 ), which reached the lowest level at day 1 after operation and recovered to normal at day 5 after operation. The postoperative levels of CD3 and CD4 in the Group A recovered near to normal at day 7 and to normal at day 14. While the postoperative levels of CD3 and CD4 in the Group B remained low level even at day 14. The level of CD8 decreased at days 1 and 5 in the Group A, then increased and remained relatively stable, while the level of CD8 increased in the Group B. The T cell subsets in both groups recovered from low to high trend at days 1-7 after surgery. The higher preoperative score had more obvious decrease and slower recovery of the T cell subsets. ConclusionsSurgical risk score has positive correlation with the change of T cell subsets and postoperative complications, which can more accurately predict the postoperative outcome of the old patients.

Objective To study the role of Anopheles anthropophagus in malaria transmission and transmission threshold so as to provide basis for vector surveillance and malaria control strategy. Methods Parasitological and entomological methods were used in the investigation at 5 villages of Xinyang City, Henan Province. Results From July to August, 1999, 74 febrile cases (10\^9% of the total population) were examined. Among them 50 were infected, the incidence in the population of surveyed spots was 7\^4%. Active detection was made in another randomly selected two villages and found that the parasite rate in the inhabitants was 2\^0%, and the positive rate of IFA was 8\^4%. Only vivax malaria was detected. An.anthropophagus and An.sinensis were collected, with An.anthropophagus as the predominant one in human dwellings. The estimated man\|biting rate and the human blood index were 4\^9388 and 0\^7858 respectively. The vectorial capacity of An. anthropophagus was 5\^5296. The critical man\|biting rate of An.anthropophagus was 0\^2407 as calculated by the formula (ma=-rlnP/abP\+n) according to Macdonald′s model.The local man\|biting rate was 20 times higher than that of the critical man\|biting rate. Conclusion The results demonstrated that An.anthropophagus is the principal vector in malaria transmission in the area. The findings imply that the critical man\|biting rate is of practicable importance in vector surveillance.

Objective To explore the dynamic changes in brain natriuretic peptide (BNP) concentration and the diagnostic value of BNP for heart failure at different time points in the early phase of acute myocardial infarction (AMI). Methods AMI patients who were admitted in our department between January 1, 2016 and July 31, 2016 and underwent emergency percutaneous coronary intervention (PCI) within 12 h after onset were enrolled in this study. All the patients received bedside examinations of BNP concentration and clinical cardiac function within 1 h after PCI and at 12, 20, 24 and 48 h after the onset of AMI. According to the peak BNP concentration, the patients were divided into high peak BNP group (>400 pg/mL) and normal peak BNP group (≤400 pg/mL). Results Seventy patients were enrolled in the study. Within 48 h after AMI onset, BNP concentration variations followed a pattern of an initial increase till reaching the peak concentration at 20 to 24 h, with subsequent gradual decrease. BNP concentrations differed significantly among the indicated time points (χ2=141.7, P<0.05) except for those between 20 h and 24 h (χ2=0.173, P>0.05). Compared with those in normal peak BNP group, the patients in high peak BNP group had an older age, a lower BMI, a longer time to perfusion, and a higher likeliness of anterior myocardial infarction and pulmonary infection (P<0.05). Logistic regression analysis showed that age, BMI and anterior myocardial infarction were independently associated with the increase of peak BNP concentration. ROC curve analysis showed that BNP concentration within 1 h after emergency PCI was unable to diagnose heart failure at that time (P>0.05), while BNP concentrations at 12, 20, 24 and 48 h after AMI onset had significant diagnostic values for heart failure (P<0.05) with areas under ROC of 0.860, 0.786, 0.768 and 0.863, and optimal cutoff values of 156.5, 313.7, 240.9 and 285.9 pg/mL, respectively. Conclusions BNP concentration increases first and then decreases in the early phase of AMI, and the peak concentration occurs at 20-24 h after the onset. The diagnostic values of BNP concentrations at different time points also vary.

Objective To explore the dynamic changes in brain natriuretic peptide (BNP) concentration and the diagnostic value of BNP for heart failure at different time points in the early phase of acute myocardial infarction (AMI). Methods AMI patients who were admitted in our department between January 1, 2016 and July 31, 2016 and underwent emergency percutaneous coronary intervention (PCI) within 12 h after onset were enrolled in this study. All the patients received bedside examinations of BNP concentration and clinical cardiac function within 1 h after PCI and at 12, 20, 24 and 48 h after the onset of AMI. According to the peak BNP concentration, the patients were divided into high peak BNP group (>400 pg/mL) and normal peak BNP group (≤400 pg/mL). Results Seventy patients were enrolled in the study. Within 48 h after AMI onset, BNP concentration variations followed a pattern of an initial increase till reaching the peak concentration at 20 to 24 h, with subsequent gradual decrease. BNP concentrations differed significantly among the indicated time points (χ2=141.7, P<0.05) except for those between 20 h and 24 h (χ2=0.173, P>0.05). Compared with those in normal peak BNP group, the patients in high peak BNP group had an older age, a lower BMI, a longer time to perfusion, and a higher likeliness of anterior myocardial infarction and pulmonary infection (P<0.05). Logistic regression analysis showed that age, BMI and anterior myocardial infarction were independently associated with the increase of peak BNP concentration. ROC curve analysis showed that BNP concentration within 1 h after emergency PCI was unable to diagnose heart failure at that time (P>0.05), while BNP concentrations at 12, 20, 24 and 48 h after AMI onset had significant diagnostic values for heart failure (P<0.05) with areas under ROC of 0.860, 0.786, 0.768 and 0.863, and optimal cutoff values of 156.5, 313.7, 240.9 and 285.9 pg/mL, respectively. Conclusions BNP concentration increases first and then decreases in the early phase of AMI, and the peak concentration occurs at 20-24 h after the onset. The diagnostic values of BNP concentrations at different time points also vary.

Objectives:To investigate the relationship between total ischemic time(TIT)and the risk of major adverse cardiovascular events(MACE,including all-cause death,non-fatal myocardial infarction,non-fatal ischemic stroke)within 1 year after primary percutaneous coronary intervention(PPCI)in patients with ST segment elevation myocardial infarction(STEMI)with TIT≤720 minutes. Methods:A total of 1 812 STEMI patients who underwent PPCI and had a TIT≤720 minutes in the Chest Pain Center of the General Hospital of the Southern Theatre Command of PLA from January 1,2011 to December 31,2021 were selected as the research subjects.Logistic regression and Cox regression models were used to analyze the association between TIT and the risk of MACE in the hospital and within 1 year after discharge.The restricted cubic spline(RCS)analysis was used to analyze the dose-response relationship between TIT and the risk of MACE. Results:Among 1 812 patients,the incidence of MACE during hospitalization was 3.26%,and the incidence of MACE within 1 year after discharge was 6.84%in 1 651 patients who survived.RCS analysis showed that TIT had an approximate logarithmic linear relationship with the risk of MACE during hospitalization and within 1 year after discharge,and the risk of MACE increased with longer TIT.Multivariate logistic regression analysis showed that compared with the group with a TIT of≤480 minutes,the risk of MACE during hospitalization increased by 77.7%(OR=1.777,95%CI:1.020-2.929,P=0.038)in the group with a TIT of more than 480 minutes.Multivariate Cox proportional hazards regression analysis showed that compared with the group with a TIT of≤280 minutes,the risk of MACE within 1 year after discharge increased by 106.7%(HR=2.067,95%CI:1.384-3.089,P<0.001)in the group with a TIT of more than 280 minutes. Conclusions:In STEMI patients after PPCI,the risk of MACE during hospitalization significantly increases when TIT exceeds 480 minutes,and the risk of MACE within 1 year after discharge significantly increases when TIT exceeds 280 minutes.