Objective To discuss the influence of tibolone on near and long-term postoperative effect of osteoporosis patients with bone cementless type artificial total hip replacement effect.Methods 136 patients with hip fracture by bone cementless type artificial total hip replacement were selected.According to the situation of osteoporosis,all patients were divided into osteoporosis group and control group.The osteoporosis group received tibolone treatment,followed up for 12 weeks.The intraoperative blood loss,operating time were analyzed.Enzyme-linked immunosorbent assay was used to determine serum bone alkaline phosphatase(sBAP),osteocalcin(sOC),C-terminal peptide collagen cross-linking Ⅰ type(sCTx).Harris hip score was applicated to evaluate hip function.Before and after treatment,lumbar vertebra bone mineral density(BMD) was detected by dual-energy X-ray absorption metry method.Results The intraoperative blood loss,operating time between the two groups had no significant differences(all P>0.05).The serum sBAP and sOC levels of the osteoporosis group were (28.41±6.13)U/L,(22.74±5.87)g/L,which were significantly lower than those of the control group[(35.18±7.21) U/L,(27.42±6.38)g/L],the serum sCTx level[(0.56±0.21)ng/mL]was higher than that of the control group[(0.42±0.11)ng/mL].The differences were statistically significant(tsBAP=5.36,tsOC=6.62,tsCTx=6.71,all P<0.05).On behalf of the hip joint function in the osteoporosis group was 58.82%,which was lower than 71.76% in the control group(χ2=6.78,P<0.05).The lumbar spine BMD of the control group at 12 weeks was higher than the osteoporosis group,but there was no statistically significant difference(P>0.05).Conclusion The type of bone cement after total hip arthroplasty patients with osteoporosis bone metabolism and bone mineral density in osteoporosis patients are poor in the hip joint function recovery is poorer,postoperatively for drug resistance to osteoporosis treatment can effectively avoid further loss of bone mass,it is worthy of further clinical promotion.

Stroke is a common neurological diseases with high morbidity,high mortality and high morbidity characteristics,which brings great suffer and economic burden to the patients and families,and has become an important research topic in contemporary medical profession.Treatment directly affects the prognosis of patients with cerebral infarction,and thus it is very important to find the most effective treatments and methods.Currently,thrombolytic therapy in acute cerebral infarction have carried out a large number of experimental studies,and achieved good results.This paper reviewed the thrombolytic therapy in acute cerebral infarctionincluding the time window,methods and drugs of thrombolysis,and the influencing factors of outcomes were also summarized and discussed.

Objective This paper is to study a new sutureless vascular bonding method. Methods New-Zealand rabbits were randomly assigned to one experimental group and one control group. 10 end-to-end bonding on rabbit femoral arteries (1.2mm vessel) were performed using the experimental technique with histoacryl glue (OB) and a central channel soluble stent. In the control group, 10 rabbit femoral arteries (1.2mm vessel) were anastomosed with the standard suture method. The patency rates and anastomotic time were recorded. The late anastomoses were evaluated with arteriograph and stoma tissue pathological section. Results The anastomosis mean time of the experimental group is 7.91 minutes and the one of the control group is 12.90 minutes. The immediate patency rates of two groups are both 100% and the late patency rates are 80% and 90% respectively. There are no haemorrhage when the clamp released and no distortion and stricture caused by sutures. Conclusion The sutureless vascular bonding method has no needs for suture needle and line, and thus the possible injuries during suture are reduced. The stent makes the vessel free from stoma stricture and binder invasion. The stoma leakage is also avoided through the adhensive. The enhanced suture speed results from the short clotting time and the hollow structure of the stent. With all the above-mentioned excellences, the method proves simple and efficient.

0.05 ), the postoperative complication and mortality rate of PG group were 13.7% and 6.8%, of TG group was all 6%.Conclusions:Proximal and total gastrectomy treatment does not significantly influence the prognosis of patients with cardia and esophgogastric junction cancer in progressive stage.

Objective:To investigate the differences in efficacy, survival outcomes, and acute and late toxicities for patients with local/regional advanced nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy (IMRT) in combination with che-motherapy (CT) and by IMRT alone. Methods:A total of 72 newly diagnosed local/regional advanced NPC patients were randomly subjected to IMRT/RT+adjuvant CT (after radiotherapy, RT) (n=42) or IMRT+adjuvant CT (after RT) (n=30). The Kaplan-Meier meth-od was used to analyze the two-year local/regional control rates, distant metastasis-free survivals, and overall survivals. The acute and late radiation toxicities were evaluated based on the toxicity criteria of the Radiation Therapy Oncology Group and European Organiza-tion for Research and Treatment of Cancer. Results:A median follow up period of 13.5 months was included in the study. The one-year and two-year local/regional control rates, distant metastasis-free survivals, and overall survival in the IMRT group were 95.0%, 80.0%, and 95.0%, and 80%, 60.0%, and 75.0%, respectively. For the IMRT+CT group, such rates were 100%, 96.4%, and 96.4%, and 100%, 92.9%, and 92.9%, respectively. The two-year local/regional control rate and distant metastasis-free survivals in the IMRT+CT group were higher than those in the IMRT group (P<0.05). Most patients had grade 1 to grade 2 acute radiation toxicities and grade 0 to grade 1 late radiation toxicities (P>0.05). No patient showed a grade 4 acute or late toxicity. The blood and gastrointestinal toxicity rates were high in the IMRT+CT group (P<0.05). Conclusion:The IMRT+CT treatment has potential advantages over the IMRT in the treatment of local/regional advanced NPC patients in terms of local/regional control and overall survival. The blood and gastrointestinal toxicity rates in the IMRT+CT group were higher than in the IMRT group but still within a tolerable range.

Background Lead exposure induces microglial cell death, of which the mechanism is unclear. Ferroptosis is a new death form and its role in microglia death has not been reported. Objective To investigate the role of ferroptosis in microglia following lead exposure in order to provide a theoretical basis for the mechanism of lead neurotoxicity. Methods Microglial cell line BV-2 cells were co-cultured with 0, 10, 20 and 40 μmol·L⁻¹ lead acetate for 24 h. The 40 μmol·L⁻¹ lead acetate group with iron chelator (DFO) was named the 40+DFO group. Changes in BV-2 cell morphology after lead exposure were observed under an inverted microscope; tissue iron kit and glutathione kit were used to detect intracellular iron and glutathione (GSH) respectively; flow cytometry was applied to detect lipid reactive oxygen species (lipid ROS) immunofluorescence intensity. Western blotting and qPCR were adopted to detect the expressions of glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11 (SLC7A11), transferrin receptor 1 (TFR-1), divalent metal transporter 1 (DMT1), ferroportin 1 (FPN1) protein and mRNA. Results Compared with the control group, the number of BV-2 cells decreased with increasing doses of lead and the cells showed a large, round amoeboid shape. The intracellular levels of iron of BV-2 cells were (1.08±0.04), (1.29±0.03), and (1.72±0.10) mg·g⁻¹ (calculated by protein, thereafter) in the 10, 20, and 40 μmol·L⁻¹ lead acetate groups, respectively, significantly higher than that in the control group (P<0.05), and the intracellular level of iron in the 40+DFO group, (1.34±0.10) mg·g⁻¹, was lower than that in the 40 μmol·L⁻¹ lead acetate group, (1.72±0.03) mg·g⁻¹ (P<0.05). Compared with the control group, the TFR-1 and DMT1 protein and mRNA expressions were increased in BV-2 cells in the 10, 20, 40 μmol·L⁻¹ lead acetate groups (P<0.05), especially in the 40 μmol·L⁻¹ lead acetate group; the FPN1 protein expression did not change significantly, but the FPN1 mRNA expressions in BV-2 cells in the 10, 20, 40 μmol·L⁻¹ lead acetate groups were significantly decreased (P<0.05). Compared with the control group, the intracellular GSH level decreased and the lipid ROS content increased in all three lead acetate groups; compared with the 40 μmol·L⁻¹ lead acetate group, the GSH level increased by 12.30% and the lipid ROS content decreased by 13.00% in the 40+DFO group (P<0.05). The expressions of GPX4 protein were reduced to 50.00%, 35.00%, and 17.00% of that of the control group in the 10, 20, and 40 μmol·L⁻¹ lead acetate groups respectively, while the expressions of GPX4 mRNA were also significantly reduced; the expressions of SLC7A11 protein and mRNA in the 20 and 40 μmol·L⁻¹ lead acetate groups were lower than that in the control group, with the most significant decrease in the 40 μmol·L⁻¹ lead acetate group (P<0.05). Conclusion Lead exposure could induce ferroptosis in BV-2 cells, in which iron transport imbalance and oxidative damage might be involved.

Objective: To explore the diagnostic efficiency of K-TIRADS, ACR-TIRADS and ATA risk stratification in computer-aided detection and diagnosis(CAD) software and the application value of CAD-assisted ultrasound physicians in diagnosing thyroid nodules. Methods: One hundred and ninety-two thyroid nodules with postoperative pathological results were retrospectively analyzed. All of them were graded by K-TIRADS, ACR-TIRADS and ATA with CAD software, and the best guide was recognized by calculating the area under the ROC curve, sensitivity and specificity. Then, based on the best guidelines for the classification criteria, the double-blind method was used to compare the ability of the same ultrasonologist to diagnose thyroid nodules before and after CAD. Results: The AUC value of K-TIRADS, ACR-TIRADS, ATA was 0.88, 0.77, 0.62 respectively in the CAD software. The difference between the two groups was statistically significant (P<0.05). There was no significant difference in the specificity between K-TIRADS and ATA(P=0.176), which were both higher than ACR-TIRADS with statistically significant differences (P<0.05). The AUC value of the diagnosis among CAD itself, ultrasound physicians and physicians combined CAD was 0.88, 0.80, 0.93, respectively. The difference between the two groups was statistically significant (P<0.05). There was no significant difference in the sensitivity between CAD itself and physicians combined CAD(P=0.163), which were both higher than ultrasound physicians with statistical significant differences(P<0.05). Among ultrasound physicians, CAD itself and physicians combined CAD, the difference in specificity between the two groups was statistically significant(P<0.05). Conclusions All the three risk stratification systems of thyroid ultrasound in CAD software have good diagnostic values, among which K-TIRADS has the largest AUC. The CAD software can assist ultrasound physicians to improve the thyroid nodule diagnostic performance, and has a good clinical application prospect.

Objective Based on the technology acceptance model,to explore the influence mechanism of technical support,perceived interactivity,perceived usefulness,perceived ease of use and perceived risk on medical staff's report intention on adverse events,and to provide path suggestions for improving medical staff's report intention adverse events.Methods The multi-stage sampling method was used to select 637 medical staffs of tertiary public hospitals in Hangzhou who used the information-based platform to report adverse events as the research respondents,and the self-developed scale of report intention on adverse events was used as the research tool,monofactor analysis were conducted by Wilcoxon rank-sum test,and the structural equation model was used to analyze the influence path of their report intention on adverse events.Results Perceived ease of use and perceived usefulness have positive effects on medical staff's report intention on adverse events(β=0.264,0.658;P＜0.001);Perceived risk negatively affected the medical staff's report intention on adverse events(β=-0.143,P＜0.001).The indirect effects of perceived usefulness and perceived ease of use on medical staff's report intention on adverse events are 0.538 and 0.205,respectively.Conclusion Perceived usefulness and perceived ease of use plays a mediating role in perceived interactivity and medical staff's report intention on adverse events.

Objective Based on the technology acceptance model,to explore the influence mechanism of technical support,perceived interactivity,perceived usefulness,perceived ease of use and perceived risk on medical staff's report intention on adverse events,and to provide path suggestions for improving medical staff's report intention adverse events.Methods The multi-stage sampling method was used to select 637 medical staffs of tertiary public hospitals in Hangzhou who used the information-based platform to report adverse events as the research respondents,and the self-developed scale of report intention on adverse events was used as the research tool,monofactor analysis were conducted by Wilcoxon rank-sum test,and the structural equation model was used to analyze the influence path of their report intention on adverse events.Results Perceived ease of use and perceived usefulness have positive effects on medical staff's report intention on adverse events(β=0.264,0.658;P＜0.001);Perceived risk negatively affected the medical staff's report intention on adverse events(β=-0.143,P＜0.001).The indirect effects of perceived usefulness and perceived ease of use on medical staff's report intention on adverse events are 0.538 and 0.205,respectively.Conclusion Perceived usefulness and perceived ease of use plays a mediating role in perceived interactivity and medical staff's report intention on adverse events.

Objective Based on the technology acceptance model,to explore the influence mechanism of technical support,perceived interactivity,perceived usefulness,perceived ease of use and perceived risk on medical staff's report intention on adverse events,and to provide path suggestions for improving medical staff's report intention adverse events.Methods The multi-stage sampling method was used to select 637 medical staffs of tertiary public hospitals in Hangzhou who used the information-based platform to report adverse events as the research respondents,and the self-developed scale of report intention on adverse events was used as the research tool,monofactor analysis were conducted by Wilcoxon rank-sum test,and the structural equation model was used to analyze the influence path of their report intention on adverse events.Results Perceived ease of use and perceived usefulness have positive effects on medical staff's report intention on adverse events(β=0.264,0.658;P＜0.001);Perceived risk negatively affected the medical staff's report intention on adverse events(β=-0.143,P＜0.001).The indirect effects of perceived usefulness and perceived ease of use on medical staff's report intention on adverse events are 0.538 and 0.205,respectively.Conclusion Perceived usefulness and perceived ease of use plays a mediating role in perceived interactivity and medical staff's report intention on adverse events.