BACKGROUND:A high incidence of deep vein thrombosis after total hip replacement does great harm to patients,so it is necessary to look for a safe and effective prevention program after total hip replacement to reduce the harm of deep vein thrombosis.OBJECTIVE:To observe the influence of comprehensive prevention scheme on deep vein thrombosis after total hip replacement.METHODS:102 cases undergoing total hip replacement were randomly divided into observation group and control group with 51 cases in each group.Patients in the observation group received the comprehensive prevention program,which is composed of three interventions: sequential cross combined with low molecular heparin,intermittent pneumatic pressure therapy and continuous femoral nerve block analgesia.In the control group,patients received low-molecular-weight heparin for anticoagulation therapy by the doctor according to his clinical experience,or intermittent pneumatic pressure therapy.The occurrence and distribution of deep vein thrombosis were compared in patients of both groups.At the same time,platelet and hemoglobin were recorded.RESULTS AND CONCLUSION:In the observation group,three patients suffered from deep vein thrombosis with an incidence of 6％.In the control group,11 patients affected deep vein thrombosis,with an incidence of 22％.There were significant differences between the two groups (P＜ 0.05).No significant difference in constituent ratio of the distribution of deep vein thrombosis was detected in the distal vein and proximal vein in patients of both groups (P＞ 0.05).Hemoglobin value was lower at 1 day after surgery compared with that pre-operation in the two groups (P＜0.05).Platelet value was lower at 1 day after surgery compared with that pre-operation in the two groups (P＞0.05).No significant difference in hemoglobin and platelet values was detected between two groups at 1 and 6 days after surgery (P＞ 0.05).Results indicated that the comprehensive prevention program containing the sequential and cross combined with low molecular heparin,intermittent pneumatic pressure therapy and continuous femoral nerve block analgesia can significantly reduce the incidence of deep vein thrombosis,and no serious complications occurred,and the effects are affirmative and reliable.

Objective To investigate the effect of glutamine on energy intake and prognosis of severe burn patients in differ-ent pathway.Methods Using retrospective study method,we brought the patients into our study from October 2010 to April 2014 in accordance with the inclusion criteria.Patients who were given the Gln before 5 days after injury through gastric bowel were brought into the EN group,others who were given the Gln after 5 days after the injury through vein were brought into PN groups. A total of 66 patients were included in this study,with 31 cases of EN group and 35 cases of PN group.Total energy intake,external and internal energy intake,nutrients heating,energy intake/energy consumption ratio,blood glucose control,insulin use and viscera damage(the blood urea nitrogen,creatinine,alanine aminotransferase,aspartate aminotransferase,total bilirubin,creatine kinase,lac-tate dehydrogenase),ICU days,hospital stays and mortality were observed in 1,2,3,4 weeks after injury.Results Within a month after the injury,the energy intake of patients in EN group were more than PN group,especially the energy from intestinal canal.Be-sides,the ICU days of patients in EN group were shorter than patients in PN group (all P <0.05).Other indicators of two groups of patients were no significant statistical difference(P >0.05).Conclusion Supplement of Gln may be more conducive to improve the intestinal function in patients with burns may be more conducive to improve the intestinal function in patients with burns,im-prove the degree of tolerance of enteral nutrition,increase energy intake and conducive to improving the prognosis of patients.

Objective To compare the contents in polysaccharide of aloe in gel of aloe with preparation in different processing methods on fresh aloe of outer cuticle and investigate their stability. It could provide technology of preparation of polysaccharide of aloe.Methods The aloe gel had been prepared through the fresh juicing method, and alcohol sinking was applied to abstract polysaccharides of aloe in proportion of sixty, seventy, eighty and ninety percent. The colorimetric method of anthracenone - thick sulfuric acid had been taken to determine contents of polysaccharide in different proportions by alcohol sinking. The contents of polysaccharide were compared among different processing methods in fresh aloe of outer cuticle, and then the stability on condition of different temperatures, pH and the reagent of reductant-oxidant with polysaccharides of aloe were investigated. Results The content abstracted from polysaccharide of aloe was the higher when the proportion was eighty percent and its character of powder was better. And content abstracted from polysaccharide of aloe with the outer cuticle was higher than that out of the outer cuticle. The powders from the polysaccharide of aloe with the outer cuticle were gray-green, gray-brown or gray-white. The powders from polysaccharide of aloe without the outer cuticle were partial-white, more well-distributed and delicate. The stability in polysaccharide of aloe was better with the condition of low temperature, reducing agent and the solution with pH from five to seven, while the stability was lower when in high temperature, oxidizing agent and the solution with strong acid and strong alkali. Conclusions The proportion of eighty percent with alcohol sinking, decorticating the outer cuticle of fresh aloe has the higher content and the better character in the polysaccharide of aloe.

Objective:To obtain phage-displayed ScFv library targeting tumor tissues and to screen for antibodies specifically binding to tumor vessels using in vivo phage display,so as to lay a foundation for diagnosis and treatment of cancer.Methods:The membrane proteins were extracted from the specimens of esophageal carcinoma,stomach carcinoma,brain cancer,lung cancer,and spinal cord tumor.The recombinant phage-antibody system was used to construct a single-chain Fv fragment(ScFv)cDNA library from the total RNA of the BALB/c mice immunized with purified membrane protein.The specific primers of VH and VL were used to amplify the cDNA of VH and VL,respectively,which were then assembled into ScFv gene with a specially constructed linker DNA.The ScFv gene was ligated into the phagemid vector pCANTAB 5E and the ligated samples were transformed into competent E.coli TG1.The transformed cells were infected with M13KO7 helper phage to yield recombinant phage.Using the animal model of human cervical carcinoma(HeLa cells),sepecific phage-ScFvs were selected by phage displaying and panning in vivo.After four rounds,24 phage-ScFvs,which were identified by PCR,were analyzed immunohistochemically.The ScFvs expressed in the tumor tissue slices and negative in control kidney tissue slices were sequenced.Results:Tomors-bearing animal models were established with 7 different kinds of carcinoma cell lines in BALB/c nude mice.It was found that inoculation with HeLa cells resulted in most satisfactory tumorigenesis in nude mice.A ScFv library of 1.6?106 was obtained and a tumor vessel specific phage-ScFv named ScFvH1(VH-linker-VL)was selected from the library.Conclusion:A tumor targeting ScFv library has been successfully constructed and a tumor vessel-specifrc antibody has been identified from the library,which provides a new way for the early diagnosis and therapy of cancer.

Objective: To investigate the targeting and anti-tumor ability of the tumor vessel-specific antibody ScFvH1 selected from phage-ScFv library, and to discuss the application of the antibody in clinical diagnosis and therapy of cancer. Methods: The ScFvH1 gene was inserted into pET-28a(+)/EGFP vector containing green fluorescent protein(GFP) gene and pTIG-Trx vector containing thioredoxin gene; the products were then expressed in E.coli and purified by using Ni-NTA. Tumor-bearing mice model was established by subcutanuous injection of cervical cancer cell line HeLa. The mice were injected with purified ScFv-EGFP fusion protein through vena caudalis and the GFP signals were observed by fluorescent microscope to evaluate the targeting ability of the antibody. Meanwhile, the mice model also received intratumoral injection of purified ScFv-EGFP fusion protein to evaluate the anti-tumor effect of the antibody. Results: Soluble ScFvH1 gene and ScFvH1-EGFP protein were successfully expressed in E.coli; a single band was showed in SDS-PAGE after the purification by Ni-NTA. We found that ScFvH1-EGFP fusion protein was enriched to tumor tissues, but there was only weak fluorescent signal when EGFP protein was injected. No EGFP signal was observed in the lung of tumor-bearing mice. Tumor inhibition experiment showed that the tumor growth in the antibody treatment group was similar to that of the PBS control group. Conclusion: The tumor vessel-specific antibody ScFvH1 selected from phage-ScFv library can specifically target tumor vessels, but it has no obvious inhibitory effect on tumor growth. Our findings pave a way for antibody in cancer diagnosis and treatment.

OBJECTIVETo study the diagnosis and surgical treatment of penis lymphangioma.

METHODSClinical data of 13 cases of penis lymphangioma were analysed restrospectively.

RESULTSThe 13 cases, treated by radical lymphangiomaectomy, were followed up for 2 to 3 years, and none of them had recurrence. This therapy affected neither the penile appearance, nor the erectile function of the patients. So their sexual life remained intact.

CONCLUSIONRadical ectomy should be the first choice of treatment for penis lymphangioma.

Adolescent ; Adult ; Child ; Humans ; Lymphangioma ; surgery ; Male ; Penile Neoplasms ; surgery ; Retrospective Studies

Objective:To investigate the role of neutrophil CD 11b (nCD 11b), soluble CD 14 subtype (sCD 14-St) and mitochondrial coupling factor-6 (CF-6) in the risk stratification of disease outcome in neonatal sepsis and its clinical significance. Methods:The clinical data of 121 septic neonates from July 2019 to March 2020 in Shanxi Children′s Hospital were retrospectively analyzed. According to the neonatal critical illness score (NCIS), the neonates were divided into non-critical group (NCIS>90 scores) with 35 cases, critical group (NCIS 70 to 90 scores) with 49 cases, very critical group (NCIS<70 scores) with 37 cases. There were 25 cases with poor prognosis (death), and 96 cases with good prognosis (survival). The C-reactive protein (CRP), procalcitonin (PCT), nCD 11b, sCD 14-St and CF-6 before treatment were detected. The correlation between nCD 11b, sCD 14-St, CF-6 and disease severity was analyzed by Spearman method; the value of nCD 11b, sCD 14-St and CF-6 in predicting poor disease outcome in sepsis neonates was analyzed by the receiver operating characteristic (ROC) curve. Results:The nCD 11b, sCD 14-St, CF-6, PCT and CRP in critical group and very critical group were significantly higher than those in non-critical group: (414.68 ± 93.29) and (532.74 ± 101.85) MFI vs. (325.45 ± 71.90) MFI, (892.40 ± 113.72) and (1 249.53 ± 95.41) ng/L vs. (784.66 ± 103.72) ng/L, (84.79 ± 28.35) and (121.66 ± 34.27) ng/L vs. (42.59 ± 13.51) ng/L, (19.24 ± 6.30) and (34.96 ± 11.95) μg/L vs. (8.89 ± 2.24) μg/L, (109.49 ± 36.77) and (247.13 ± 82.06) mg/L vs. (56.84 ± 17.25) mg/L; the indexes in very critical group were significantly higher than those in critical group, and there were statistical differences ( P<0.05). Spearman correlation analysis result showed that nCD 11b, sCD 14-St and CF-6 were positively correlated with disease severity in sepsis neonates ( r = 0.719, 0.813 and 0.823; P<0.01). The nCD 11b, sCD 14-St, CF-6, PCT and CRP in poor prognosis neonates were significantly higher than those in good prognosis neonates: (618.58 ± 146.92) MFI vs. (374.55 ± 120.03) MFI, (1 516.91 ± 194.38) ng/L vs. (828.13 ± 175.67) ng/L, (165.84 ± 25.63) ng/L vs. (62.51 ± 16.75) ng/L, (43.46 ± 10.14) μg/L vs. (20.19 ± 6.30) μg/L and (321.09 ± 94.56) mg/L vs. (88.24 ± 29.19) mg/L, and there were statistical differences ( P<0.01). ROC curve analysis result showed that the area under the curve (AUC) of nCD 11b, sCD 14-St and CF-6 for predicting poor disease outcome in sepsis neonates were 0.763, 0.796 and 0.838 (95% CI 0.678 to 0.836, 0.713 to 0.864 and 0.760 to 0.899), and the AUC of combination the 2 indexes was 0.921 (95% CI 0.858 to 0.962). Conclusions:The nCD 11b, sCD 14-St and CF-6 are associated with the disease severity and prognosis in sepsis neonates, and can be used as markers for risk stratification of disease outcome and assessment prognosis.

ObjectiveTo systematic analyze the intervention effects of early ambulation on ICU acquired weakness(ICU-AW) in ICU patients. MethodsThe Cochrane Library, PubMed, EMBASE, MEDLINE, CBM, CNKI and Wanfang database were searched via computer for randomized controlled trials on early ambulation to prevent ICU-AW in ICU patients from the data base establishment date to February 10th, 2019.After screening literature, extracting data and evaluating the quality of literature, Meta-analysis was carried out with RevMan 5.3 software. ResultsFinally, 11 randomized controlled trials were included. Meta-analysis results showed that the incidence of ICU-AW was RR=0.52, 95%CI was (0.41, 0.66); muscle strength (MRC-score) WMD=8.08, 95%CI was (6.27, 9.81); Barthel index WMD=18.24, 95%CI was (7.27, 29.2); mechanical ventilation time was WMD=-1.29, 95%CI was (-1.96, -0.61); ICU hospitalization time was MD=-1.81, 95%CI was (-2.78,-0.84); total hospitalization time WMD=-3.39, 95%CI (-5.91, -0.88). ConclusionsBased on the present evidence, early ambulation can reduce the incidence of ICU-AW, improve the activity of daily life ability of patients,shorten the duration of mechanical ventilation, length of stay in ICU and hospital, which is worthy of clinical application.

Objective To investigate the nutritional status of patients with heart failure and its effect on all-cause mortality.Methods A total of 351 patients with chronic heart failure,who were consecutively admitted to the East Hospital of Shanghai from March 2013 to November 2015,were put into the heart failure with reduced left ventricular ejection fraction (HFrEF) group.They were compared to 222 controls who were admitted during the same period for preclinical heart failure.After a median follow-up time of 606 days,108 patients of the HFrEF group died,compared to 11 of the controls.Logistic regression was used to analyze correlations of all-cause mortality with the patients' body mass index (BMI),serum albumin and other factors.Results Compared to the controls,patients with chronic heart failure had lower BMI [(22.71±3.95) kg/m2 vs.(24.23±3.66) kg/m2,t=4.331,P=0.000],total cholesterol [(3.81±0.99) mmol/L vs.(4.03±0.96) mmol/L,t=2.638,P=0.009],albumin [(38.18±5.03) g/Lvs.(40.18±6.12) g/L,t=3.874,P=0.000] and prealbumin [(187.67±61.83) mg/L vs.(211.94±65.44) mg/L,t=3.937,P=0.000].Within the HFrEF group,patients with lower BMI had higher mortality (36.0％ vs.22.4％,P=0.008).Logistic regression suggested BMI,age were independent predictors of all-cause death.Conclusions Patients with chronic heart failure had high incidence of malnutrition,and those with BMI＜22 kg/m2 had higher risk of mortality.Serum albumin and BMI not only reflected nutritional status of the patients but had significant implications on prognosis.

Objective:To understand the medical cost ratio and its influencing factors of breast cancer chemotherapy and molecular targeted therapy in a hospital, for reference for reasonable control of medical cost.Methods:The first page data of all breast cancer chemotherapy and molecular targeted therapy cases in a tertiary hospital from January to June 2021 were selected to extract the data of age, hospitalization expenses, hospitalization time, complications or complications. The influence of each index on the distribution of medical expense ratio was analyzed by single factor analysis and chi-square test was used for comparison between groups.Results:A total of 3 109 cases of chemotherapy and molecular targeted therapy for breast malignant tumors were included, of which very low-rate, low-rate, high-rate and very high-rate accounted for 7.04%(219 cases), 58.32%(1 813 cases), 30.81%(958 cases) and 3.83%(119 cases) respectively. In addition to the way of admission, there were significant differences in the distribution of medical cost rates under different ages, time consumption index, complications or concomitants, admission departments, treatment methods and medical insurance types( P<0.01). Conclusions:There were many factors affecting the medical cost rate of breast malignant tumors. Relevant departments should expand the pilot scope of DRG payment, promote the multi-disciplinary diagnosis and treatment mode of tumors, refine the DRG grouping scheme, to provide standardized and homogeneous diagnosis and treatment services for tumor patients, and reasonably control the excessive growth of medical costs.