Objective To investigate the prevention and management strategies of in-hospital complications in the hip replacement in elderly patients(≥80 years old) Methods The data of 42elderly patients with hip replacement between Oct.2004 and Dec.2006 were collected and analyzed.Their age ranged from 80 to 96 years with an average of 84.6 years.Twenty-four cases were associated with severe osteoporosis(Dorr Ⅲ),13 with coronary heard disease,10 with arrhythmia,7with diabetes,5 with cerebral paralysis.Twenty five cases had a cemented stem bipolar femoral head replacement,2 had uncemented stem bipolar femoral head replacement,7 had cemented total hip replacement,3 had revision of total hip replacement. Results No death occurred during operations,1 died postoperatively due to dislocation at the 5th day postoperation.One case had coma for 1 week after general anaesthesia.5 had temporary cognitive handicap,38(90.5%)were able to walk at the aid of walker with easement of pain before discharging. Conclusions To gain good results in elderly patients with hip arthroplasty,less invasive and quick anaesthetic technique and operative procedures are encouraged.Meticulous preoperative preparation.active preventing and treating the intraoperative and postoperative complications should be emphasized.

Objective To observe the therapeutic effect of extracorporeal shock wave therapy on the pain caused by soft tissue injury.MethodsThere were 63 cases with tennis elbow, 106 cases with frozen shoulder, and 45 cases with the pain syndrome. All the 214 cases were divide into study group and control group, 107 cases in each group. The study group received extracorporeal shock wave therapy around the pain point; the control group recieved partial closure, massage, and drugs treatment. Visual Analogue Scale (VAS) were assessed before and 4 weeks, 8 weeks and 12 weeks after treatment.ResultsThe scores of VAS showed no difference between the two groups before and 4 weeks after the treatment (P＞0.05). The study group improved in VAS 8 weeks and 12 weeks after the treatment compared to the control group (P＜0.01); the overall efficacy rate was higher in the study group than in the control group (P＜0.01).ConclusionExtracorporeal shock wave therapy is effective to treat the pain caused by soft tissue injury.

Objective To study on the expression of the eukaryotic recombinant vector carrying HlyX gene of Leptospira serovar Lai in mammalian cell and explore the humoral immune response in BALB/c mice immunized with the recombinant plasmid. Methods The HlyX gene was amplified from Leptospira serovar Lai genomic DNA by PCR and inserted into pcDNA3.1 vector. After transformed into E. coli DH5α,the recombinant plasmid was assayed for identification by PCR analysis,restriction nuclease enzyme digestion and sequencing. The recombinant plasmid was transfected into COS-7 cells,then RT-PCR and Western blot were performed to test the expression of the target gene. The recombinant plasmid was injected intramuscularly into BALB/c mice for three times at intervals of two weeks,and the antibody titer was measured by ELISA. Results PCR showed the full length HlyX gene was about 1100 bp. PCR analysis,restriction nuclease enzyme digestion and sequencing indicated the recombinant vector was constructed successfully. After the plasmid Was transfected into COS-7 cells,a fragment about 1100 bp was found by RT-PCR and a specific band relative molecular mass(Mr)about 40×103,which was consistent with the expected size of the target proteins was showed by Western blot. ELISA showed the antibody titer in BALB/c mice immunized by the HlyX gene of Leptospira serovar Lai can elicit high-titer antibody in BALB/c mice,which has laid the foundation for the application of the DNA vaccine.

Objective To investigate the effect of comfort nursing based on teamwork on patients after laparoscopic myomectomy of hysteromyoma .Methods One hundred and fifty-six patients who chose laparoscopic myomectomy of hysteromyoma were randomly divided in the intervention group and the control group, each with 78 cases.The control group received conventional nursing while the intervention group received comfort nursing including preoperative interactive supervision , intranperative comfort nursing and postoperative visits.Effect of nursing was compared between two groups .Results The operation time , called the eye opening after the operation , called the open fist time and the tracheal extubation time was respectively ( 52.63 ±7.25 ) min, (18.62 ±1.65)min, (22.15 ±1.32)min and (25.37 ±1.52)min in the intervention group, shorter than (58.72 ±7.31)min,(23.05 ±1.72)min,(25.67 ±1.38)min and(29.62 ±1.56)min in the control group, and the differences were statistically significant ( t=5.224 ,16.415 ,16.279 ,17.233 , respectively;P<0.01).The pain score 12, 24, 48 and 72 h after operation was respectively (4.32 ±1.42),(3.29 ±1.27), (2.37 ±1.05),(1.25 ±1.02)in the intervention group, lower than(5.47 ±1.52),(4.56 ±1.31),(3.56 ± 1.08),(1.82 ±1.05)in the control group, and the differences were statistically significant (t=4.883,6.147, 6.977 ,3.439 , respectively; P <0.05 ) .The time of first being out of bed was ( 12.35 ±3.17 ) h in the intervention group and ( 17.52 ±3.23 ) h in the control group , with statistically significant difference ( t =10.089,P<0.05).Sleep time 24, 48 and 72 h after surgery as well as hospitalization time was respectively (5.72 ±2.31)h,(6.55 ±1.58)h,(7.87 ±1.25)h and (7.13 ±1.28)d in the intervention group, better than (17.52 ±3.23)h,(3.59 ±2.35)h,(5.37 ±1.63)h,(6.58 ±1.27)h and(8.67 ±1.59)d in the control group, and the differences were statistically significant ( t =5.709,4.591,6.393,6.663, respectively; P <0.01).The incidence of complication was 6.41%in the intervention group, and 24.36%in the control group, with statistically significant difference (χ2 =9.652 ,P<0.05 ) .Conclusions Comfort nursing for patients after laparoscopic myomectomy of hysteromyoma can improve their surgical compliance , shorten operation time and awakening time , reduce postoperative complications and enhance surgical effect .