Objective To prepare polyclonal antibodies of anti Nogo-66, the extracellular region of one central nervous system neurite regeneration inhibitor Nogo, which could be used to further identification and functional study of Nogo molecule.Methods Preparing rabbit anti rat Nogo-66 polyclonal antibodies with a purified Nogo-66 fusion protein expressed in E.coli system. Studying its specificity by Western-blot and immuno-histochemical techniques and identifying its biological activity in PC12 cells.Results The high titer (1∶[KG-*2]10 000) anti rat Nogo-66 polyclonal antibodies were obtained.This antibody could specifically recognize the Nogo protein expressed in E.coli system.Immuno-histochemical staining indicated that the Nogo was widely expressed in rat spinal cord neurons and oligodendrocytes.It could effectively block the neurite extensioninhibition of Nogo protein in PC12.Conclusion Successful preparation of anti rat Nogo polyclonal antibodies provides a useful tool in identification or further functional study of Nogo molecule.

Objective To determine postoperative resting energy expenditure ( REE) in children with congenital heart disease ( CHD) requiring open heart surgery , to compare measured resting energy expenditure (MREE) with current predictive equations (PEE), and to investigate the possible influencing factors on the metabolic status of the postoperative CHD children .Methods From February 2015 to June 2015 , 150 ventila-ted children admitted to the cardiac intensive care unit after surgery for congenital heart disease in Shanghai Children's Medical Center were enrolled consecutively .Indirect calorimetry ( IC) measurements were performed using metabolic cart 4 hours after surgery .General clinical data were recorded .Results Totally 104 male and 46 female patients were enrolled, with a median age of 14 months (8.3-36.0 months).The non-protein re-spiratory quotient of patient was 0.79 ±0.20, MREE was (264.76 ±61.74) kJ/(kg· d), and PEE using Schofield equations was (278.51 ±93.42) kJ/(kg· d).Although there was no significant differences (P=0.096 ) between MREE and PEE , the agreement was poor between them ( R2 =0.119 ) .Multivariate stepwise regression analysis showed that MREE had significant positive correlation with risk adjustment in congenital heart surgery (RACHS-1) score (P=0.012) and negative correlation with age (P=0.010).Up to 97.33%of children (146/150) had lower energy intake compared with MREE on the 1st postoperative day .Conclu-sions MREE does not increase after surgery in CHD children;however , the substrate utilization is influenced . Factors influencing the postoperative REE include RACHS-1 score and age.The energy intake at 1st day after surgery is generally lower than REE in these children .

AIM:To clarify the impact of heart shock factor 4b (Hsf4b) K65R mutation on the regulation of downstream protein expression .METHODS:Non-functional Lys mutant plasmid pWZL-blast-HA-Hsf4b/K65R was genera-ted by replacing single , homologous amino acids using KOD-Plus-Mutagenesis-Kit.Mouse lens epithelial mLEC stable cell lines expressing Hsf4b or Hsf4b/K65R were constructed by lentivirus infection .The expression of Hsf4b in the mutant and the wildtype mLEC cells was confirmed by Western blotting .The expression of Hsf4b downstream proteins such as heat shock protein ( Hsp)70, Hsp90, Hsp27 and CryAB was examined by Western blotting and real-time PCR.RESULTS:The results of PCR and DNA sequencing confirmed the successful construction of mLEC Hsf 4b/K65R mutant.The K65R mutation didn’t influence Hsf4b expression in the mLEC cells.After K65R mutation in Hsf4b, the expression levels of Hsp27 and CryAB were down-regulated and the expression of Hsp 70i and Hsp90a upregulated.CONCLUSION: pWZL-blast-HA-Hsf4b/K65R can be used to construct a stable cell line by infecting with lentivirus .Hsf4b/K65R mutation influ-ences the regulation of downstream heat shock proteins .

Objective To investigate the protective effect of fibrinolytic therapy on renal function in patients with IgA nephropathy. Methods The clinical data of 84 patients with idiopathic IgA nephropathy were analyzed in a retrospective cohort study. According to different drugs of fibrinolytic therapy, the patients were divided into three groups including control group(n=23), urokinase group (n=32) and fibrinogenase group (n=29). Twenty-four-hour urine protein excretion, serum albumin, estimated glomerular filtration rate (eGFR), prothrombin time and fibrinogen level between the three groups after 6-month and 1-year treatments were compared. Results Compared to the group before treatment, the urine protein excretions were decreased in all 3 groups with 6-month and 1-year treatments (P<0.01). The urine protein excretion in the urokinase group with 6-month and 1-year treatments were lower than that in the control group (P<0.01). The urine protein excretion in the fibrinogenase group with 1-year treatment were lower that in the control group (P<0.05). After 1-year treatment, the eGFR in urokinase group was significantly increased compared with the control group (P<0.05). Conclusion Fibrinolytic therapy can decrease the 24-hour urine protein excretion and improve the renal fuction in those patients with idiopathic IgA nephropathy independent of glucocorticoids and immunosuppressive agents.

Objective To evaluate the efficacy and accuracy of hammering reverse guide wire technique for safe placement of anterior column retrograde intramedullary screw in pelvic and acetabular surgery.Methods From September 2015 to March 2018,46 patients with pelvic or/and acetabular fracture involving the anterior column were treated with hammering reverse guide wire technique for safe placement of anterior column retrograde intramedullary screw at Department of Orthopaedics,Lishui Municipal Central Hospital.They were 28 men and 18 women,aged from 21 to 85 years (mean,55.6 years).There were 34 pelvic ring fractures,9 acetabular fractures and 3 combined pelvic ring and acetabular fractures.After the anterior lateral spine of pubic tuberosity was drilled by a guide pin and drill bit as the entry point,a reverse guide wire was knocked into the bone lightly by a hammer.For each retrograde intramedullary screwing into the acetabular anterior column,we recorded operation time,fluoroscopic frequency,and attempts to establish an acceptable screw pathway by the guide pin.The accuracy of screwing and the quality of fracture reduction were evaluated by imaging examination.For each patient,we recorded fracture union time and complications.Functional recovery of the pelvis and acetabulum was assessed by postoperative physical examination at the last follow-ups.Results The operation time of retrograde intramedullary screwing for the 46 patients averaged 28.9 minutes (from 16 to 55 minutes);the fluoroscopy frequency averaged 16.3 times (from 9 to 35 times);an acceptable screw pathway was established by the first attempt in 43 of the 46 patients (93.5％) and re-established after adjustment of the guide pin in the other 3.Forty patients were followed up for an average of 15.2 months(from 6 to 36 months).Postoperative CT scan and three-dimensional reconstruction showed that all the screws had been placed safely and accurately in the acetabular anterior column.Implant loosening and fracture displacement occurred in one case and lower limb thrombosis in another.No nail breakage,fracture nonunion,incision necrosis or infection,neurovascular injury or femoral head necrosis was observed.All fractures united after an average of 14.7 weeks (from 12 to 18 weeks).According to the Majeed scoring at the last follow-ups,the pelvic and acetabular function was evaluated as excellent in 29 cases,as good in 9,and as fair in 2,giving an excellent and good rate of 95.0％.Conclusion Hammering reverse guide wire technique is an effective method for safe placement of anterior column retrograde intramedullary screw in pelvic and acetabular surgery,because it can increase accuracy of screwing and reduce intraoperative radiation,operation time and incidence of complications though it is simple.

Objective To evaluate the clinical application of a three-dimensional (3D) printing personalized guide for medial open wedge high tibial osteotomy(MOWHTO) in the treatment of knee varus osteoarthritis.Methods A retrospective study was conducted of the 16 patients with knee varus osteoarthritis who had been treated at Department of Orthopaedics,Zhengzhou Central Hospital of Zhengzhou University from January 2016 to January 2017.They were 6 men and 10 women,aged from 49 to 65 years (mean,55.8 years).Bilateral knees were involved in 2 cases and a unilateral knee was involved in 14 cases.Their disease duration ranged from one to 12 years (mean,5.3 years).A personalized guide for MOWHTO was designed and manufactured by 3D printing for every patient preoperatively.All the patients underwent knee arthroscopy before osteotomy which was assisted by the personalized guide.The femorotibial angle (FTA),medial proximal tibial angle (MPTA),weight bearing line (WBL),posterior tibial slope (PTSA) and the patellofemoral height Insall-Salvati index (IS index) were measured on their X-ray radiographs preoperatively and 6 months postoperatively.The Hospital for Special Surgery (HSS) score and visual analogue scale (VAS) were used to evaluate the outcomes at the final follow-ups.Results All surgeries were successful.The 16 patients were followed up for 6 to 12 months (mean,9.1 months).The FTA,MPTA,WBL and IS index at postoperative 6 months were significantly improved than the preoperative values (P ＜ 0.05).There was no significant difference between postoperative PTSA and preoperative PTSA (P =0.990).The mean VAS scores for the 16 patients at the final follow-ups were 0.8 ± 0.7 peints,significantly better than the preoperative ones (4.2 ± 0.9 points) (P ＜ 0.05);their mean postoperative HSS scores (89.3 ± 6.7 points) were also significantly improved than the preoperative ones (61.9 ± 10.5 points) (P ＜ 0.05).According to the HSS scores at the final follow-ups,the surgical outcomes were excellent in 14 knees,good in 3 and fair in one.Conclusion A 3D printed osteotomy guide can be used to perform precise osteotomy in MOWHTO for knee varus osteoarthritis,leading to effective correction of the alignment of the lower limb and good short-term surgical outcomes.

Objective To investigate the infection status after heart transplantation (HT) in a third-grade class-A hospital from 2018 to 2023, and explore its risk factors. Methods A retrospective analysis was conducted on the data of 314 patients who underwent HT surgery from January 2018 to July 2023, they were divided into infection group and control group according to postoperative infection situation, the possible influencing factors of HT postoperative infection were analyzed by univariate analysis, and the risk factors of HT postoperative infection were screened by multivariate Logistic regression analysis. Results A total of 91 patients(28.98%)developed postoperative infections, with infection sites of respiratory tract and blood. Logistic regression analysis showed that the main risk factors for postoperative infection in HT patients included complicating with chronic lung disease, surgical time ≥5 h, long retention time of postoperative thoracic drainage tube, long postoperative urinary tube retention time, long postoperative mechanical ventilation time, and preoperative Alb < 35 g/L. Conclusion Complicating chronic lung disease, surgical time ≥5 h, long postoperative thoracic drainage tube retention time, long postoperative urinary tube retention time, long postoperative mechanical ventilation time, preoperative Alb < 35 g/L are related to postoperative infection of HT. Therefore, active intervention should be carried out for the above factors in patients to reduce the risk of infection.

From the perspective of management, the authors established an analysis framework for the option mechanism of this information system, and analyzed the option mechanism of the system in such aspects as organization and management, optional and maintenance management, resources management, and shared interactive management. It is held that a medical insurance information system is already established to cover both rural and urban residents in China, along with a comprehensive operation mechanism. However such a mechanism is still defective in terms of communication mechanism, investment and resources development. It is recommended to make up in terms of improving stakeholders coordination mechanism, building diversified investment and financing mechanism, enhancing data quality, as well as system promotion and application, data sharing and business synergy capabilities.

ObjectiveTo evaluate the clinical effectiveness of doctor-nursing integration mode on the prevention of venous thromboembolism(VTE) in geriatric patients with hip fracture. MethodsFrom January to June of 2018, a total of 120 elderly patients with hip fracture admitted to the orthopaedic department of Ningbo First Hospital were selected in this study. According to the time of admission, they were divided into the control group (n=58)and the observation group (n=62). The conventional nursing mode was adopted in the control group and doctor-nursing integration nursing mode was adopted in the observation group. The two groups were compared in terms of the scores of VTE related knowledge, swelling degree of the affected limbs, the plasma D-Dimer level and the incidence of DVT on the lower limbs as well as the pulmonary thrombus. ResultsOne week after surgery, the patients in the observation group achieved higher score in the VTE related knowledge than the control group with statistical significance (P＜ 0.05); one day and one week after surgery, the observation group was lower than the control group in the swelling degree of the 10cm above the hip of the affected limb; one week and two weeks after surgery, the observation group was lower than the control group in the plasma D-Dimer level, both with statistical significance (P＜0.05); the control group's incidence of perioperative DVT on the lower limbs was 11.4% , lower than the 25.8% in the observation group with statistical significance (P＜ 0.05). ConclusionsDoctor-nursing integration nursing model can help to improve the compliance with the thrombosis prevention of the elderly patients with hip fracture, relieve the symptoms related to perioperative VTE and reduce the incidence of DVT on the lower limbs.

Objective? To establish, implement and evaluate the pain control quality system for patients with total knee arthroplasty(TKA). Methods? Through literature search and interviews with medical staff and retrospective reviews of TKA cases in orthopedic wards, the problems in pain control of TKA patients during perioperative period were analyzed. According to the evidence-based practice guideline and the existing problems in pain nursing practice, the pain control quality system was constructed. From January to November 2018, 75 TKA patients in Orthopedic Department, Ningbo First Hospital were selected as the research objects and randomly divided into the control group (n=35) and the intervention group (n=40). The control group received the routine pain nursing mode, and the intervention group was managed by the pain control quality system. The static and dynamic VAS scores on the 1st, 3rd and 7th day after TKA, the incidence of analgesia-related complications and the quality of pain nursing were compared between the two groups. Results? There were significant statistical differences in static and dynamic VAS scores of knee joint between the two groups on the 1st, 3rd and 7th day after operation (P＜0.05). There was no statistical difference in the incidence of analgesia-related complications between the two groups (P＞ 0.05). The total score of TKA perioperative pain nursing quality in the intervention group was 84 (80, 85), while that of the control group was 56 (53, 58). The difference between the two groups was statistically significant (P＜0.01). Conclusions? The construction of pain control quality system can effectively improve the level of perioperative pain management of TKA, the quality of pain nursing care, and improve the perioperative pain of TKA patients.