[Objective]To evaluate the effect of integrated management of blood loss in total knee arthroplasty (TKA ) between gypsum fixed up, ice compress,elastic bandage and only with elastic bandage. [Methods]From January 2006 to August 2008,107 patients undergoing TKA were randomized divided into integrated management group( 54 cases) and control group( 53 cases).Sex,age and deseases in two groups were comparative.The patients in integrated management were treated with elastic bandage,gypsum fixed up,leg elevated by 35 degrees at the hip with knee extended, continuous cold therapy.The patient in control group were only treated with single elastic bandage.The loss of blood during 2 h, 12 h, 24 h postoperative were analyzed.[Results]The blood loss was 170 ml(85~505 ml),210 ml(105~560 ml), 260 ml(110~580 ml)at 2 h、12 h、 24 h postoperative in integrated management group,and 180 ml(110~900 ml), 320 ml(115~930 ml),390 ml(170~970 ml) in control group.The blood loss in integrated group was obviously and a statistically significant difference was found between the two groups (P

Objective:To analyze the therapeutic effect and safety of finasteride on aged patients with isolated systolic hypertension (ISH)complicated benign prostatic hyperplasia (BPH).Methods:A total of 84 aged ISH + BPH pa-tients admitted from Jun 2011 to May 2013 were selected.According to medication plan,they were divided into fin-asteride group (n=44)and routine treatment group (n=40,only received routine treatment because they cannot use finasteride).Course of treatment was all six months.International prostate symptom score (IPSS),quality of life (QOL) questionnaire score,prostate-specific antigen (PSA),incidence rate of acute urinary retention,maximum u-rinary flow rate (Qmax),postvoid residual urine (PRV),prostate volume (PV)and incidence rate of adverse reac-tions were compared between two groups.Results:Compared with routine treatment group,there were significant reductions in IPSS [(13.2±2.4)scores vs.(9.4±1.1)scores],PRV [(21.4±4.6)ml vs.(9.0±2.3)ml],PV [(36.8±3.8)ml vs.(29.5±3.0)ml],PSA [(2.45±0.74)μg/L vs.(1.26±0.48)μg/L]and incidence rate of acute urinary retention (17.50% vs.9.09%),P<0.05 or <0.01,and significant increase in Qmax [(10.2±2.4) ml vs.(13.7±3.8)ml]and QOL score [(3.1±1.0)scores vs.(4.7±1.5)scores]in finasteride group (P<0.05). There were no significant difference in incidence rates of adverse reactions between two groups,P>0.05 all.Con-clusion:Therapeutic effect of finasteride is significant and adverse reactions don’ t increase significantly in aged pa-tients with isolated systolic hypertension complicated benign prostatic hyperplasia.

Background and purpose:miR-124 is considered to be a tumor suppressor in multiple tumors, including lung cancer, prostate cancer, bladder cancer, and breast cancer. However, its function is unclear in gastric cancer. This study aimed to explore the expression of miR-124 in human gastric mucosal epithelium cells and different gastric cancer cells, as well as gastric cancer tissues and matched para-cancerous tissues. The correlations of miR-124 expression with gender, age, histological grade, T stage, TNM stage, lymph node metastasis and prognosis of gastric cancer patients were analyzed.Methods:A real-time lfuorescent quantitative polymerase chain reaction (RTFQ-PCR) was employed for detecting the expression of miR-124 in human gastric mucosal epithelium cells and gastric cancer cells. The expression of miR-124 in gastric cancer tissues and matched para-cancerous tissues was detected by in situ hybridization.Results:The RTFQ-PCR results indicated that the expression of miR-124 was down-regulated in MKN-74, MKN-28, MKN-45, MGC-803, SGC-7901 and AGS cells compared to GES-1 cells.In situ hybridization showed that miR-124 was strongly expressed in normal gastric mucosa. However, low expression, focal positive expression or lack of miR-124 expression were observed in gastric cancer tissues. Statistical analysis showed that miR-124 was close-ly correlated to histological stage, TNM stage and node metastasis of gastric cancer patients, but not the age, gender and tumor size. The OS and DFS of the patients with low expression of miR-124 were shorter than that of the patients with high expression of miR-124. Multivariate analysis suggested that miR-124 down-regulation was an independent prog-nostic factor for survival in patients with gastric cancer.Conclusion:miR-124 is down-regulated in gastric cancer cells and tissues. The expression of miR-124 is correlated to histological stage, TNM stage, node metastasis and prognosis.

Objective To explore the effect of neural cell adhesion molecule (NCAM) on adhesion,migration and morphology of mouse bone marrow-derived mesenchymal stem cells (BMSCs).Methods We isolated and cultured BMSCs from wild-type and NCAM gene knockout mice.The expression of NCAM was detected by Western blot and immunofluorescence.Wound healing and adhesion assays were used to detect cell migration and adhesion ability respectively.The morphological changes were observed and the expressings of protein β1 integrin,E-cadherin,β-catenin and N-cadherin were analysed by Western blot.Results The migration and adhesion of BMSCs were significantly reduced after NCAM gene knockout.Meanwhile,the expression of β1 integrin was lower than those in wild-type BMSCs (P<0.01).The morphology of NCAM gene knockout BMSCs changed from irregular to flattened,and expressed epithelial identification marker E-cadherin and β-catenin (P<0.05).However,the expression level of mesenchymal identification marker N-cadherin was decreased (P<0.01).Conclusions NCAM is involved in adhesion and migration of BMSCs via regulating the expression of β1 integrin.Furthermore,NCAMmay negatively regulate the mesenchymal-epithelial transitions of BMSCs.

Objective To observe the effects of ginsenoside Rg1 group on the structure and function of rat skeletal muscle with exercise-induced fatigue.Methods SD rats were randomized into blank control group,model group and ginsenoside Rg1 group.The rats in the model group and ginsenoside Rg1 group received medium-intensity treadmill running to induce exercise-induced fatigue.Ginsenoside Rg1 group was given ginsenoside Rg1 50 mg?kg-1?d-1 for 2 continuous weeks during the modeling.After treatment,malondialdehyde(MDA)content,superoxide dismustase(SOD) activity,mitochondrial membrane potential and free calcium content in the rat skeletal muscle were measured.Meanwhile,ultrastructure of the skeletal muscle was observed under the electron microscope.Results In the model group,SOD activity,mitochondrial membrane potential,and free calcium content were decreased,MDA content was increased,and the difference was significant as compared with the blank control group(P

Objective Study the relationship between HLA antibodies production and the number of Gravidity.Methods A total of 856 pregnant women of first pretanal in Xiasha Hospital of Sir Run Run Shaw Hospital of Zhejiang University from Nov 2016 to Mar 2017 were recruited.The blood samples were collected during 24-28 weeks of pregnancy,and the expression of platelet-specific alloantibody was detected by solid-phase red cell adherence assay.Results There were 67 positive HLA antibody in pregnant women,and the antibody positive rate was 7.8％.There were 15 positive HLA antibody in 334 first pregnant women,14 in 214 two or more pregnancy pregnant women without abortion,10 in 107 pregnant women with once abortion,28 in 223 pregnant women with two or more abortion.The antibody positive rate respectively is 4.5％,6.5％,9.3％ and 12.6％.The production of HLA antibody was significantly associated with the numberof gravidity.Conclusion The antibody positive rate of two or more pregnancy is significantly higher than the fisrt pregnancy.

Objective To investigate the feasibility of resection of internal wall for pancreatic mucinous cystic neolplasms (MCN).Methods Successive observation and cyst wall thickness measurement of the pathological sections of 24 cases with pancreatic MCN admitted in our hospital during 2008-2011.One patient with pancreatic tail MCN was treated by resection of internal wall.Results The cyst wall thicknesses of the 24 cases vary from 2 mm to more than 2 cm,and the thicknesses of fibrous envelop near pancreatic vary from 0.1 mm to 8.0 mm.The fibrous envelop thickness of 17 cases were more than 0.5 mm(70.8％,17/24).These cases could be treated with resection of internal wall.Pancreatic leakage occurred in 8 of the 24 patients (33.3％,8/24).The patient treated by resection of internal wall had no pancreatic leakage.Conclusion We consider that 70.8％ cases of pancreatic MCN could be treated by resection of internal wall to cure MCN and avoid the possibility of postoperative pancreatic fistula.

Objective To evaluate urinary β2-microglobulin (β2-MG) and retinoid binging protein (RBP) in monitoring of early renal impairment in chronic hepatitis B (CHB) patients with long-term adefovir dipivoxil (ADV) treatment. Methods Three hundred and fifty five with CHB admitted in Shaoxing Municipal Hospital from June 2009 to June 2011 were enrolled in the study, among whom 180 cases study group) were treated with ADV monotherapy (n=100) or ADV + lamivudine (LAM) combination therapy (n=80); and 175 cases (control group) were treated with entecavir (ETV). Serum creatinine, urinary β2-MG, RBP and creatinine were measured and glomerular tration rate (eGFR) was estimated regularly during 5-year follow up. Kaplan-Meier method was used to calculate the cumulative incidence of changes in urinary β2-MG and RBP. Results Five-year follow-up results showed that in study group 2, 6, 10, 14 and 24 cases developed urinary β2-MG abnormality in year 1, 2, 3, 4 and 5 of treatment, respectively; and 2, 7, 11, 16 and 20 cases developed urinary RBP abnormality in year 1, 2, 3, 4 and 5 of treatment, respectively; eGFR decreased 20%-30% from baseline in 20 cases, 30%-50% in 13 cases and >50% in 2 cases. The decrease of eGFR ≥30% in 5 years was significantly correlated with urinary RBP and β2-GM abnormality. However, both serum creatinine and eGFR remained stable during the 5 years of follow-up in control group; only 2 cases developed urinary β2-MG abnormality and 3 cases developed urinary RBP abnormality. Conclusions Urinary RBP and β2-MG are sensitive biomarkers of early renal injury during long-term ADV treatment in CHB patients, and ADV should not be used as first-line treatment for CHB.

Objective There is no quantization scheme for the early ambulation in patients with gastrointestinal tumor after operation of enhanced recovery .The aim of this study was to explore a suitable objective method of postoperative ambulation for gastro -intestinal tumor patients . Methods Sixty six gastrointestinal tumor postoperative patients were randomly assigned to two groups :ex-perimental group ( 33 cases ) and control group ( 33 cases ) .Enhanced recovery was adopted in the both groups afterthe operation . Wireless smart bracelets ( fitbit flex) were used in the experimental group , and the ambulation of patients was monitored by the hand of synchronous real time computer digital panel .At the same time, the patients was supervised for positive ambulation . Traditional quantitative methods of electronic pedometer were used in the control group.The postoperative ambulation , effect and compliance were compared between the two groups . Results Postoperative ambula-tion steps in the experimental group were increased compared with the control group on the days 1, 2, and 3postoperative, and the data were (208.70 ±45.76) vs (144.36 ±47.68), (560.73 ±148.67) vs (407.00 ±85.92), and (894.70 ±91.68) vs (674.00 ±73.06) steps (P<0.05).The first time of early ambulation, flatus, ca-tharsis, and compliance of ambulation showed significant difference in the two groups (P<0.05). Conclusion Wireless intelligent monitoring bracelet is objective and effective for monitoring and quantifying postoperative ambulation .It is superior to the traditional quantitative methods , and can improve the effect and compliance of the ambulation .Moreover , it can promote postoperative recovery in patient with enhanced recovery surgery .

Objective To generate data on the current medical rehabilitation resources in Hubei province so as to improve the management of rehabilitation quality.Methods Medical institutions on the second level and above were investigated using a questionnaire which covered installations,personnel,equipment and field of operations.Results A total of 176 questionnaires were recovered.Among them,166 (94.3％) of the hospitals had established a department of rehabilitation medicine,and 122 (69.3％) had set up an independent rehabilitation ward,accounting for a total of 3,359 beds.Altogether,there were 1,260 rehabilitation physicians (36.7％ of the assigned personnel),904 therapists (26.3％) and 1,272 nurses (37％).Senior physicians,therapists and nurses were 26％,3.1％ and 28.3％ of the respective totals.Conclusion Rehabilitation medicine in Hubei Province remains relatively poorly developed.It is weak in terms of building the discipline,management and devices,especially in a serious lack of professionals and rehabilitation therapists.