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.

OBJECTIVETo investigate the influence of parathyroid hormone and estrogen on alveolar bone metabolism of castrated female rats.

METHODSSixty-six female Wistar rats which were healthy and 4 months old were divided into two groups, with group SHAM (n = 18) and group ovariectomy (OVX) (n = 48). After 8 weeks of ovariectomy, the osteoporosis model was confirmed by examing 8 ovariectomized and sham-operated rats. The rest 10 rats in group SHAM were the control group (group A). The rest 40 rats in group OVX were divided into ovariectomized group (group B), ovariectomized and treated with estrogen (group C), ovariectomized and treated with parathyroid hormone (group D), ovariectomized and treated with estrogen and parathyroid hormone (group E) at random with 10 in each group. Group A and B injected physiological saline (1 mL x kg(-1)), group C injected estradiol benzoate (10 microg x kg(-1)), group D injected parathyroid hormone (20 microg x kg(-1)), group E injected parathyroid hormone (20 microg x kg(-1)) and estradiol benzoate (10 microg x kg(-1)). The intraperitoneal injection were maken every other day to rats in each group, which continued for 8 weeks. The bone mineral density (BMD), bone histomorphology and serum Ca, P, alkaline phosphatase (ALP) were measured after therapy.

RESULTSAfter 8 weeks of ovariectomy, the lumbar BMD of ovariectomized rats were significantly declined compared with those of the sham-operated rats (P < 0.05). Eight weeks later after the drug use, the BMD, %Tb.Ar, Tb.Th, Tb.N in group C, D, E were slightly elevated compared to group B, especially the group E (P < 0.05). Serum calcium and phosphorus values did not change significantly (P > 0.05). ALP values in group B was significantly higher than that in group A (P < 0.05).

CONCLUSIONIntermittent application of parathyroid hormone in small doses can increase alveolar BMD of castration rats and improve their bone structure. And it can have synergy effects on the treatment of osteoporosis if it is used combining with estrogen.

Alkaline Phosphatase ; Animals ; Bone Density ; Estradiol ; analogs & derivatives ; Estrogens ; Female ; Osteoporosis ; Ovariectomy ; Parathyroid Hormone ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar

Objective To introduce the technique of metal-on-metal hip resurfacing arthroplasty,evaluate its preliminary clinical results and review the factors which affect the results.Methods From January 2006 to October 2010,104 patients (116 hips) with osteonecrosis of the femoral head,hip osteoarthritis,hip dyplasia,or ankylosing spondylitis were treated with the total hip resurfacing arthroplasty.Among them,59 patients (66 hips) were male,and 45 patients (50 hips) were female,with an average age of 39.7 years (range,16-67 years).Standard operation technique was performed for all patients with Conserve Plus prosthesis.Each patient was followed up at 1 month,3 months,6 months,1 year postoperatively.Results Three patients (4 hips) were lost,so 101 patients (112 hips) were followed up for an average period of 33 months (range,9-66 months).The average Harris hip score was improved significantly from 37.6±6.3 preoperatively to 91.3±5.3 at final follow-up; 104 hips were excellent,7 hips were good,1 hip was poor,and the excellent and good rate was 99.1％.At final follow-up,the average abduction angle of the acetabutar cup was 42.7°(range,36°-55°); the average femoral prothesis stem-shaft angle was 138.5° (range,132°-146°).Two patients presented with heterotopic ossification (Brook Ⅲ and Brook Ⅱ ).One patient presented with prothesis dislocation,which healed after being treated with manual reduction.There was no femoral neck fracture,infection,or prosthesis loosening.Conclusion With strict patient selection criteria and optimized technique,the short-term results of metal-on-metal hip resurfacing arthroplasty are satisfactory.

Objective To research the protective effects of totalPanax Japonicus extract on learning memory, antioxidation, and anti-apoptosis of aging mice,and explore the mechanism. Methods Male mice were randomly divided into normal group, model group, Vitamin E (VE) group, Panax Japonicus extract low and high dose group. Except for the normal group, the other groups were injected withD-gal on the back of the neck subcutaneously to establish aging model. Normal group and model group were given a gavage with saline and each treatment group was given a gavage with totalPanax Japonicus extract and VE once a day for 7 weeks after the aging model established. All mice were be measured their learning and memory ability in the eighth week. After the test, the morphological changes of CA1 neurons were observed by HE stain. SOD, GSH-Px, MDA levels in brain tissue were measured by biochemical method, the expressions of Bcl-2 and Bax mRNA were evaluated by RT-PCR.Results Mice inPanax Japonicus extract low and high dose group could spend less time in searching for the platform, improve the learning and memory ability. TotalPanax Japonicus extract increased the activity of SOD and GSH-Px, while decreased the content of MDA. In addition, it could increase the expression level of Bcl-2 mRNA and reduce the expression level of Bax mRNA as well.Conclusion TotalPanax Japonicus extract has anti-aging effect.

Objective To investigate the effects of Dihuangyinzi(DHYZ) on behaviors and RAGE/p38 pathway in APP/PS1 mice.MethodTwenty APP/PS1 dementia mice were randomly divided into model group(n=10) and Chinese medicine group(n=10).The blank group was C57 BL/6 J normal mouse(n=10).The mice in Chinese medicine group were intragastric administration with DHYZ (9.75 g·kg-1·d-1).The mice in model group and blank group were treated with distilled water.After 30 days,the abilities of learning and memory of mice were detected by Morris water maze.The expression of amyloid-beta1-42(Aβ1-42) in the hippocampus and cortex was detected by immunohistochemistry.Reactive oxygen species of brain tissue were detected by DCFH-DA Methods in the brain of APP/PS1 mice.Gene expression level of receptor for advanced glycation end products(RAGE) was measured by real-time polymerase chain reaction (RT-PCR) in the cortex and hippocampus of APP/PS1 mice.The expression of phospho-mitogen-activated protein kinases (p38) was analyzed with Western blot and immunofluorescence analysis in the cortex and hippocampus of APP/PS1 mice.Results Behavioral Results showed that DHYZ significantly increased the distance((23.088±7.083)cm) and residence time((1.961±1.230)s)of effective area in Morris water maze on the fifth day(P<0.05,P<0.01)and remarkably increased the number of effective area crossings((1.607±0.405) times) and plats((0.893±0.283) times) in Morris water maze on the fifth day(P<0.01,P<0.05).DHYZ also significantly reduced the intracelluar ROS level(122.611±7.630) in the brain(P<0.01),and DHYZ could depress the expression of RAGE(1.467±0.081,7.983±0.136) and phosphorylation of p38 (0.376±0.026,0.538±0.016)in the cortex and hippocampus of APP/PS1 mice(P<0.01,P<0.05).Conclusions The Results demonstrate that DHYZ can partly improve memory impairment of APP/PS1 mice by the inhibition of RAGE/p38 pathway.

Objective To identify key micro RNAs (miRNAs) and thier regulatory pathways through analyzing messenger RNAs (mRNAs) and miRNAs expression profiles in animal models of hypoxic ischemic encephalopathy (HIE).Methods Eighteen 7-d old SD rats were divided into hypoxic-ischemic group and sham-operated group (n=9) by random number table. And rats in each group were divided into 0 h sub-group, one d sub-group and 7 d sub-group (n=3) according to different times after model making. Modified Rice method was used to establish the HIE rat models in the hypoxic-ischemic group, and only the left common carotid artery was isolated in the sham-operated group. The cerebral cortices of the two groups were taken for high-throughput sequencing to establish mRNAs and miRNAs expression profiles. TargetScan, miRanda and PITA were used to match differential miRNAs with corresponding homologous mRNAs, and to analyze and predict their related target genes and signal pathways.Results (1) As compared with those in the sham-operated group, the enzymatic analysis of the mRNAs sequencing results of the brain tissues in the hypoxic-ischemic group showed that the biological characteristics of the HIE models in the 0 h sub-group were likely to be reflected in cell localization, cell proliferation, migration, and vascular development, and associated with complement and antigen presentation, tumor necrosis factor (TNF) signaling pathway and cytokine receptors; those in the one d sub-group were likely to be reflected in single organism signal, and response to external stimuli, and vascular development, and associated with complement, antigen presentation, adhesion, and extracellular matrix receptors; those in the 7 d sub-group were likely to be involved in cell localization, single organism signaling, and cell adhesion, and associated with complement, antigen presentation and cytokine receptor. (2) After comparing the differentially expressed miRNAs detected by miRNAs sequencing with the mRNAs sequencing results of the same group, it was found that there were differences in the expressions of rno-mir-181b-5p, rno-mir144-3p, rno-mir-873-5p, rno-mir-411-5p, rno-mir-132-3p, rno-mir-486, rno-mir-127-5p and rno-mir-6321; functional analysis found that these miRNAs mainly involved in inflammatory response and regulation of neurological function in various periods.Conclusion Through the complex negative regulatory network, miRNAs may participate in the key pathogenesis of HIE at various stages through various inflammatory mechanism and play an important role in the neuronal plasticity of the neonatal hypoxic ischemic brain tissue and the development of the nervous system.

Objective: To understand the distribution of masculine and feminine traits and gender roles in primary school students who did not enter the Tanner Ⅱ stage in Xiamen and to provide a reference for promoting the development of mental and physical health of children. Methods: The present study was based on the blood pressure cohort of children in Xiamen. All 823 participants were from grade two, three, four of primary school. Participants were asked to obtain children’s masculine and feminine traits, gender role types (masculine, feminine, androgynous, undifferentiated) and heterogeneity through the Children’s Sex Role Inventory. In this study, non-parametric tests and chi-square tests were used to compare the differences of masculine and feminine traits, gender role types and heterogeneity rates between different groups. Results: The masculine traits of this study scored (2.80±0.52), and the feminine traits scored (2.95±0.55). The proportion of masculine, feminine, androgynous and undifferentiated was 12.8%, 11.9%, 39.1% and 36.2%, respectively. The proportion of undifferentiated among boys (41.8%) was higher than girls (31.5%), while the proportion of androgynous (34.6%) was lower than girls (43.0%), the differences were of statistical sigificance(χ2=9.22, 6.02, P<0.05). The rate of gender role heterogeneity was 7.0%, and there was no significant difference between different gender and age groups(P>0.05). Conclusion The gender roles of primary school students in Xiamen are mainly androgynous and undifferentiated, and the distribution of gender role is different in boys and girls. More specifically, the gender roles of boys were mainly undifferentiated, and girls were mainly androgynous. In general, the proportion of gender role heterosexuals is a little higher, which should be paid more attention and appropriate guidance by schools and parents.

Objective: To analyze the association between masculine and feminine traits, gender role in students and family factors, and to provide a scientific basis for promoting the healthy development of children and adolescents gender role. Methods: Cluster random sampling method was used to selected 823 students from 2 schools of Xiamen in May, 2018, participants were asked to report individual masculine and feminine traits through the Child s Sex Role Inventory, and then gender role was divided into four types (masculine, feminine, androgynous, undifferentiated). Non parametric tests, generalized linear model, and Logistic regression model were used to explore the association between masculine and feminine traits, gender role and family factors. Results: Compared with the boys from the nuclear family, the masculine traits were lower in boys of other families by 0.282( 95% CI = -0.452 --0.110), and the feminine traits were also lower by 0.192 (95% CI =-0.369--0.014). Compared with boys of middle socioeconomic status (SES), the masculine traits of boys from low SES decreased by 0.157 (95% CI =-0.286--0.029), and the feminine traits decreased by 0.140 (95% CI =-0.274--0.005). The proportion of androgynous in boys from other families was significantly lower than boys from the nuclear family ( OR =0.45, 95% CI =0.21-0.94), with the proportion of undifferentiated significantly higher than nuclear family 2.33 (95% CI =1.22-4.44). The proportion of androgynous in boys from low SES was significantly lower than boys from middle SES ( OR =0.59, 95% CI =0.35-0.99), with the proportion of undifferentiated significantly higher than middle SES 1.62 (95% CI =1.00-2.65). Among girls, the differences in masculine and feminine traits and gender role of different family factors were not statistically significant ( P >0.05). Conclusion The masculine and feminine traits and gender role in students are associated with family structures and socioeconomic status, especially in boys. Therefore, the family environment is an important factor affecting children s gender role, and the healthy development of children s gender role needs parents attention and correct guidance.

Objective: To analyze the correlation between the scores of masculinity and femininity and parental rearing pattern in lower grade primary school students in Xiamen, and to provide a policy suggestions and reference basis for establishing a correct concept of gender role among children and adolescents. Methods: A cluster random sampling method was used to select 823 students from two primary schools in Xiamen. Masculinity and femininity scores were assessed by Children s Sex Role Inventory(CSRI), while attitudes and behaviors of parental rearing pattern were obtained through EMBU. Regression analyses were used to analyze the correlation between masculinity and femininity scores and parental rearing pattern. Results: Masculinity scored 2.82 ( 2.41 ,3.24) and 2.82 (2.47,3.18), femininity scored 2.87 (2.40,3.20) and 3.13 (2.73,3.47) among boys and girls, with no significant gender difference ( P >0.05). Masculinity and femininity scores varied significantly by parental emotional warmth and understanding(father: Z/H =44.61, 37.24；mother: Z/H=41.68, 46.64, P <0.05). Among boys, increasing parental emotional warmth and understanding and paternal excessive interference were associated with higher masculinity and femininity scores. Increasing rejection and maternal deny were associated with lower masculinity scores. Among girls, increasing the understanding of emotional warmth of fathers was associated with masculinity and femininity scores, increasing excessive interference from mothers was associated with lower masculinity scores ( P <0.05). Conclusion There are gender differences in the relationship between parental rearing pattern and masculinity and femininity scores. In particular, increasing parents emotional warmth and understanding and reducing mothers punishment and harshness, rejection and denial, and other negative parenting styles could facilitate healthy development of masculinity and femininity among primary school students.

Objective:To investigate the feasibility, efficacy and adverse reactions of programmed death-1(PD-1) inhibitors in patients with acquired immunodeficiency syndrome (AIDS) complicated with malignant tumor.Methods:From September 2020 to August 2021, patients with AIDS complicated with malignant tumor in Zhongnan Hospital of Wuhan University were enrolled. Data including basic information, laboratory test results, CD4 + T cell count, human immunodeficiency virus (HIV) viral load were collected. Patients were continuously administered intravenously PD-1 monoclonal antibody until disease progression or intolerant toxicity reaction occurred. Adverse reactions during treatment were recorded.And treatment outcomes were assessed once every 12 weeks after treatment. HIV viral load was measured after treatment once a week for four consecutive times, then once four weeks for two consecutive times, and then once every 12 weeks. Results:Ten patients were included in the study, including seven males and three females, three cases of Hodgkin′s lymphoma, two cases of cervical cancer and hepatocellular carcinoma respectively, one case of non-Hodgkin′s lymphoma, non-small cell lung cancer and anal cancer respectively. There were four patients with CD4 + T cell count of 100 to 200 cells/μL and two patients with CD4 + T cell count lower than 100 cells/μL. All patients had completed at least three cycles of treatment with PD-1 monoclonal antibody, HIV viral load remained lower than 20 copies /mL. Three cases achieved complete response and three cases achieved partial response. Adverse reactions were cutaneous capillary endothelial proliferation (CCEP) (seven cases), major bleeding (three cases), and hearing impairment (one case). Conclusions:PD-1 inhibitor has no adverse effect on the continuous suppression of HIV viral load and has an effect on tumor control, so it is a viable choice in AIDS patients complicated with tumor. However, due to its considerable adverse reactions, multidisciplinary cooperation is needed to reduce the risk of complications and deal with serious complications.