Objective To study the correlated mechanisms and clinical effect of hidden hemorrhage after total hip arthroplasty (THA) and total knee arthroplasty(TKA). Methods From March 2001 to May 2005, 61 patients were treated with THA and 73 patients were treated with TKA. The patients treated with THA involved 22 males and 39 females with an average age of 68 years(range 61-79 years). The patients treated with TKA involved 23 males and 50 females with an average age of 73 years(range 65-77 years). All arthroplasties were primary and unilateral, and the 24 h fluid resuscitation was not more than 2000 ml. Using Gross formula, the true total blood loss was calculated depending on height, weight and pre- and post-operation Hct, and the hidden hemorrhage was got by subtracting the visible blood loss from total loss. Results Following THA, the mean total loss was 1520 ml and the hidden hemorrhage 482 ml(32%). Following TKA, the mean total loss was 1508 ml and the hidden hemorrhage was 776 ml(52%). The difference of hidden hemorrhage between THA and TKA was significan different(P

[Objective]Postoperative analgesia with the use of parenteral opoids or epidural analgesia can be associated with troublesome side effects.Good perioperative analgesia facilitates rehabilitation,improves patient satisfaction,and may reduce the hospital stay.We investigated the analgesic effect of locally injected drugs around a total knee prosthesis.[Method]Thirty-eight patients undergoing total knee arthroplasty were randomized either to reveive a periarticuiar intraoperative injection containing bupicaine,morphine,epinephrine,hydrocordisone or to reveive no injection.We compared the PCA consumption at the some time point after tatal knee arthroplasty.Visual analog scores for pain,preoperation and postoperation,6 weeks after operation were collected.[Result]The patients who had received the injection used significantly less patient-controlled analgesia over the first 24 hours after the surgery.They had lower visual analog scores for pain 24 hours and 48 hours after operation.No cardiac or central nervous system toxicity was observed.[Conclusion]The perioperative analgesia protocol improved patient satisfaction,pain control and minimizes side effects after total kneearthroplasty.

Objective To explore the clinical application for various radiographic body in patients with osteoarthritis of the knee.Methods The exact data of various image body for the joint cavity of knee and patella-femur was got by making use of radiographic body for double knee joint weight-bear AP & LAT and flexuosity weight-bear PA,flexuosity weight-bear axial position for double patella and weight-bear double total length lower extremities.Results Data of the knee joint exterior angle for 75 patients with osteoarthritis of the knee weight-bear AP and keep down AP was measure.Software of statistics for partnership t test was employed and that P

OBJECTlVE To investigate the mechanism of verapamiI in the treatment of type 2 Iong QT syndrome(LQT2)using a rabbit Ieft ventricuIar myocardiaI wedge preparation. METHODS E-4031 (0.5 μmoI·L-1 )was used to induce the LQT2 modeI after rabbit Ieft ventricuIar wedge preparations were equiIibrated for 1 h,and verapamiI(0.5,1.0 and 2.5 μmoI·L-1 ,respectiveIy)was perfused in different groups. Data were coIIected for a period of 30 min starting 30 min after adding the respective drug. Transmembrane action potentiaIs of endocardiaI and epicardiaI myocardium were recorded simuItaneous-Iy at a basic cycIe Iength of 2000 ms(S1S1)together with a transmuraI ECG. The effect of verapamiI (0.5,1.0 and 2.5 μmoI·L-1 )on action potentiaI duration at 90% repoIarization(APD90 ),QT intervaI, transmuraI dispersion of repoIarization(TDR)and the deveIopment of earIy afterdepoIarization(EAD) and torsades de pointes(TdP)were evaIuated in the LQT2 myocardiaI wedge modeI. RESULTS E-4031 (0.5 μmoI·L-1 )markedIy proIonged endocardiaI and epicardiaI APD90 and QT intervaI( P﹤0.01),and dramaticaIIy increased TDR(P﹤0.01). Spontaneous or programmed eIectricaI stimuIation-induced EAD and TdP were aIso observed in the modeI. VerapamiI(0.5,1.0 and 2.5 μmoI·L-1 )dose-dependentIy abbreviated endocardiaI and epicardiaI APD90 and QT intervaI(P﹤0.01),significantIy decreased TDR(P﹤0.01),and suppressed EAD and TdP in the LQT2 modeI. Concordant but stronger effects on the eIectro-physioIogicaI properties of the LQT2 modeI were noticed when nifedipine was perfused. CONCLUSlON VerapamiI inhibits TdP in the LQT2 modeI by reducing TDR and suppressing EAD.

BACKGROUND: With social development, the average life span is prolonged. The issue of aging has increasingly attracted people's attention. It is necessary to promote the health status and the guality of life of the elderly..OBJECTIVE: To understand the status and distribution features of several common diseases which influence the quality of life of elderly.DESIGN: Random cluster sampling methods and a cross-section survey.SETTING: Beijing Institute of Geriatrics of Beijing Hospital.PARTICIPANTS:Totally 1 558 old people aged ≥60 years living in 10 communities affiliated to Jianguomen district office of the Eastern District of Beijing City,and 8 villages affiliated to Xiangyang and Henan Villagers'Commissions of Shunyi County of Beijing from May 1997 and October 1997 were recruited.In fact,1 434 persons responded,with a response rate being 92％,319 males and 498 females came from the city;242 males and 375 females came from the villages.METHODS:Questionnaires were filled up,and physical examinations were conducted in all the elderly. MAIN OUTCOME MEASURES: The 6 common diseases were observed among the elderly: Hyperplasia of prostate, abnormal audition, cartaract ,osteoarthritis, fracture and constipation.RESULTS:Totally 1434 elderly entered the stage of result analysis.①The incidence of hyperplasia of prostate in the males from the urban areas was lower than that in the rural areas (61.4％,65.7％, P ＜ 0.01 ). ② The incidence of abnormal audition among the elderly from the urban areas was lower than that in the rural areas (53.9％,64.7％,P ＜ 0.01).③ The incidence of cataract of the two eyes in the elderly from the urban areas was higher than that in the rural areas(46.4％,44.4％, P ＜ 0.01). ④ The incidence of osteoarthropathy in the elderly from the urban areas was higher than that in the rural areas (24.4％,14.9, P ＜ 0.01). ⑤ The incidence of fracture in the elderly from the urban areas was higher than that in the rural areas (14.2％,9.1％, P ＜ 0.05). ⑥ The incidence of constipation of the elderly in urban areas was lower than that in the rural areas(18.2％,23.0％,P ＜ 0.05).CONCLUSION:There is a difference between the elderly from the urban areas and the rural areas in hyperplasis of prostate,abnormal audition, cataract, osteoarthropathy, fracture and constipation, and this is related with the economy, nutrition, medical conditions and cultural traits.Therefore, attention should be attached to nutrition and health knowledge of the elderly and prevention and treatment of common diseases among the elderly people.

Objective:To analyze the composition and functional characteristics of the intestinal microflora in novel coronavirus pneumonia patients with arterial stiffness, in order to provide empirical evidence for rational use of intestinal microecological modulators.Methods:Patients with novel coronavirus pneumonia admitted to our hospital between April 5 and April 19, 2020 were enrolled as research subjects.They were divided into the stiffness group and the control group according to the results of arterial stiffness.Stool samples were collected within 7 days of admission.Intestinal flora DNA was analyzed and entered into a database, shotgun metagenomic sequencing was performed, and bioinformatics analysis was conducted based on sequencing results.Results:A total of 16 patients with novel coronavirus pneumonia were included in this study, including 7 in the stiffness group and 9 in the control group.Brachial-ankle pulse wave velocity and blood pressure were higher in the stiffness group than in the control group( P<0.05). Beta diversity analysis at the phylum level showed that there were significant differences in the composition of the intestinal flora between the two groups( P<0.05). Patients with arterial stiffness had a lower relative abundance than the controls in fecal Holdemanella, Mitsuokella, Deinococcus, Lachnospira, Turicibacter, Butyrivibrio, Sporomusa, and Halanaerobium, species associated with the production of short-chain fatty acids(SCFAs), regulation of energy metabolism, anti-radiation, anti-oxidative stress and anti-inflammatory effects.The Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis showed that the intestinal flora in the control group was mainly involved in the pathways of lipopolysaccharide biosynthesis, metabolism of SCFA and other amino acids, and membrane transport, while the intestinal flora in the stiffness group was mostly concerned with the pathways of amino acid metabolism and DNA damage repair. Conclusions:The use of microbial agents capable of increasing short-chain fatty acids in patients with novel caronavirus infection may contribute to the restoration of intestinal flora homeostasis.

Objective:To explore the effects of different concentrations of 2-hydroxybenzylamine(2-HOBA)on atherosclerosis and vascular smooth muscle cell senescence and the underlying mechanisms.Methods:Fourteen apolipoprotein E-deficient(ApoE-/-)mice were used to establish an atherosclerosis model and were divided into two groups(n=7)using the random number method: a high-fat diet(HD)group and a high-fat diet plus 2-HOBA(1 mg/ml)(HD+ HOBA)group.Pulse wave velocity was used to assess vascular stiffness and a treadmill was used to assess exercise endurance.Oil Red O staining was used to detect the size and number of atherosclerotic plaques.Masson staining was used to detect the morphology of collagen fibers and elastic fibers in the plaque, the size of the necrotic core area of the plaque, and the thickness of the fibrous cap.Mouse smooth muscle cells were treated with different concentrations of 2-HOBA(100 μmol/L, 250 μmol/L and 500 μmol/L)to establish an H 2O 2-induced senescence model.Senescence-associated β-galactosidase staining was used to detect cell senescence.Real-time quantitative polymerase chain reaction(RT-qPCR)was used to detect the mRNA expression levels of senescence-related secretory phenotype factors, and Western blot was used to detect the expression levels of senescence-related signaling proteins. Results:Compared with the HD group, the HD+ HOBA group showed that the area and number of aortic atherosclerotic plaques were decreased, and the atherosclerotic plaques were stabilized.In addition, compared with the HD group, vascular stiffness in the HD+ 2-HOBA group decreased by 26%(2.59±0.32 mm/ms vs.3.50±0.28 mm/ms), with a statistically significant difference( P<0.01), and exercise endurance increased by 62%[(143.74±24.25)m vs.(233.50±30.21)m, P<0.01], suggesting that 2-HOBA was able to improve aortic vascular stiffness and exercise endurance in mice.2-HOBA ameliorated H 2O 2-induced vascular smooth muscle cell senescence and decreased the mRNA levels of H 2O 2-induced senescence-associated secretory phenotype factors such as interleukin-1β, interleukin-6, tumor necrosis factor-α and monocyte chemoattractant protein-1.Meanwhile, 2-HOBA also inhibited the expression of p53 and p21, the key signaling factors of senescence. Conclusions:2-HOBA suppresses the development and progression of atherosclerosis through inhibiting oxidative stress-related p53/p21 signaling activation and ameliorating vascular smooth muscle cell senescence and the aging-related inflammatory phenotype.

The population is commonly susceptible to the 2019 novel coronavirus(2019-nCoV), especially the elderly with comorbidities.Elderly patients infected with 2019-nCoV tend to have higher rates of severe illnesses and mortality.Immunoaging is an important cause of severe novel coronavirus pneumonia(NCP)in the elderly.Due to the combination of underlying diseases, elderly patients may exhibit a typical manifestations in clinical symptoms, supplementary examinations and pulmonary imaging, deserving particular attention.The general condition of the elderly should be considered during diagnosis and treatment.In addition to routine care and measures such as oxygen therapy, antiviral therapy and respiratory support, treatment of underlying disease, nutritional support, sputum expectoration, complication prevention and psychological support should also be considered for elderly patients.Based on literature review and expert panel discussion, we drafted the Key Points for the Prevention and Treatment of the Novel Coronavirus Pneumonia in the elderly, aiming to provide help with the prevention and treatment of NCP and the reduction of harm to the elderly population.