Objective:To investigate the influence of preoperative thyroid dysfunction on the 30-day postoperative mortality and complications in elderly patients with hip fracture.Methods:A retrospective analysis was conducted of the 349 elderly patients with hip fracture who had been admitted to Department of Orthopedic Trauma, Beijing Luhe Hospital Affiliated to Capital Medical University from January 2018 to December 2019. They were 108 males and 241 females, with an average age of 76.3 years (from 60 to 104 years). There were 190 femoral intertrochanteric fractures and 159 femoral neck fractures. By the preoperative level of thyroid function, the patients were divided into a normal function group of 290 cases and a dysfunction group of 59 cases. The 2 groups were compared in terms of hospital stay, mortality and incidence of complications within 30 days postoperation.Results:In this cohort, the rate of 30-day postoperative mortality was 3.4%(12/349) and the incidence of 30-day postoperative complications 14.6%(51/349). The 2 groups were comparable because there was no significant difference between them in the preoperative general data except for the preoperative comorbidity of coronary heart disease ( P>0.05). In the dysfunction group, the hospital stay averaged (10.2±6.9) d, the rate of 30-d postoperative mortality 1.7%(1/59) and the incidence of 30-day postoperative complications 16.9%(10/59), which were insignificantly different from those in the normal function group [(10.7±7.5) d, 3.8%(11/290) and 14.1%(41/290), respectively] ( P> 0.05). Conclusion:Since preoperative thyroid dysfunction does not affect the 30-day postoperative mortality and postoperative complications in the elderly patients with hip fracture but no definite thyroid disease, routine thyroid function screening is not recommended for them.

Objective: To analyze the expression of tight junction protein 3(claudin-3) in colorectal cancer and its relationship with the development, metastasis and prognosis of colorectal cancer. Methods: From February 2013 to February 2015, 78 patients with colorectal cancer operated in the People's Hospital of Sanmen County were selected in this study.The tissues of colorectal cancer and adjacent tissues were collected and claudin-3 expression was detected.The relationship between claudin-3 and clinicopathological features of colorectal cancer was analyzed. Results: The positive rate of claudin-3 in cancer tissues(83.33%) was higher than that in paracancerous tissues(48.72%), and the difference was statistically significant(χ²=20.832, P<0.01). The positive rate of claudin-3 in the poorly differentiated group(100.00%) was significantly higher than that in the well-differentiated group(85.71%) and the well-differentiated group(52.63%)(χ²=19.209, P<0.01). The claudin-3 positive rate with lymphatic metastasis(97.30%) was higher than that without lymphatic metastasis(70.73%), and the difference was statistically significant(χ²=9.882, P<0.01). The claudin-3 positive rate in patients with less than 3 years of survival (91.11%) was higher than that in patients with more than 3 years of survival(72.73%)(χ²=4.633, P<0.05). Conclusion The expression of claudin-3 is related to the occurrence, development and lymphatic metastasis of colorectal cancer, and can predict the prognosis of the patients.

As patients undergoing orthopedic surgery are a high-risk group for venous thromboembolism (VTE), clinical guidelines suggest anticoagulant drugs for VTE prophylaxis during perioperative period. Global antithrombotic guidelines vary in recommendations for anticoagulant drugs, but there is a general consensus in favor of using low-molecular-weight heparin (LMWH) as the first choice for prophylaxis, followed by unfractionated heparin, fondaparinux, warfarin, aspirin, and other direct oral anticoagulants (DOACs). Of them, aspirin is an inexpensive, widely used antiplatelet drug with limited complications and clear efficacy in prevention of myocardial infarction, stroke, and certain specific cancers. It was also used early for venous thromboembolism prophylaxis in orthopedic patients after surgery. Clinical experience of orthopedic physicians in North America has shown the effectiveness of aspirin in VTE prevention over several decades so that aspirin continues to be used to this day, but its use for VTE prophylaxis is less common in Europe and Asia. Historically, the role and efficacy of aspirin in VTE prevention have been the subjects of considerable controversy, for the early and recent research findings contradict each other, and recommendations conflict in different guidelines. This review focuses on the advancements in clinical evidence and guideline recommendations regarding the use of aspirin for VTE prophylaxis in major orthopedic surgeries.

OBJECTIVE： To study the chemical constituents in the ethyl acetate extract of Balanophora involucrate， and to provide reference for further enriching chemical constituent of the plant and the development and utilization of B. involucrate. METHODS： The whole plant of B. involucrate was extracted with 75％ ethyl alcohol. The extraction was carried out by petroleum ether， dichloromethane， ethyl acetate and n-butyl alcohol in turn. The chemical compounds from ethyl acetate extract part were isolated and purified by silica gel column， gel column and semi-preparative HPLC. The structures were identified on the basis of spectral spectrum （mass spectrum， hydrogen spectrum and carbon spectrum） data and literature reports. RESULTS： Thirteen compounds were isolated from ethyl acetate extract part of B. involucrate， identified respectively as pyracanthoside （1）， 5，7，3′ ，5′ -tetrahydroxyflavanone （2）， naringenin （3）， homoeriodictyol （4）， hesperetin （5）， sakuranetin （6）， eriodyctiol （7）， aureusidin-6-O-β-D-glucopyranoside （8）， penicillic acid （9）， dihydropenicillic acid （10）， 2-methyl-3-foroic acid （11）， 5-hydroxymaltol （12） and 5， 7-dyhydroxy chromone （13）. Most of them were dihydroflavones. Compounds 2 to 13 are isolated from Balanophora genus for the first time. CONCLUSIONS： The study enriched the chemical constituents of the Balanophora genus and lays foundation for quality evaluation of B. involucrate.

Objective To evaluate the clinical value of single-pill combination(SPC)of perindopril and amlodipine for the treatment of hypertension and provide reference for the selection and rational use in medical institutions.Methods A comprehensive clinical evaluation index system was established based on literature research and expert demonstration.Therefore,the safety,effectiveness,economy,innovation,suitability and accessibility of drugs were analyzed qualitatively and quantitatively.Results A total of 12 studies reported the outcome of perindopril and amlodipine SPC,including efficacy and safety.Perindopril amlodipine SPC was safe,and there was no significant difference in the incidence of adverse events during treatment compared with monotherapy,monotherapy combination or other antihypertensive SPC.In terms of effectiveness,perindopril and amlodipine SPC had clear antihypertensive effect,which could significantly reduce systolic blood pressure,diastolic blood pressure,pulse pressure difference and heart rate,and the blood pressure compliance rate of perindopril and amlodipine SPC was better than that of amlodipine or perindopril monotherapy group.Compared with other depressurized SPCs,it showed better or non-inferior effect.Perindopril amlodipine SPC,as a patented drug,has good innovation,high patient compliance,and has been included in China's medical insurance catalog,but the current medical institutions have a low supply rate,and drug prices and affordability are still at a relatively high level.Conclusion Perindopril amlodipine SPC has significant advantages in safety,effectiveness,suitability and innovation,but its economy and accessibility still need to be improved.

Heart failure is a severe manifestation or advanced stage of various heart diseases,with high mortality and readmission rates.The 2024 guidelines for the diagnosis and treatment of heart failure,which are on the 2018 guidelines,combined with new evidence and China's national conditions,provide a comprehensive and systematic description and recommendation on the classification,diagnosis,prevention,treatment,comorbidity,and management of heart failure.This article reviewed the update of the therapeutic drugs section.

Monoclonal immunoglobulin deposition disease is rare in medical practice. The light and heavy chain deposition disease is characterized by deposition of monoclonal antibodies in the basement of membrane. Kidney is the most frequently involved organ. There was a male patient diagnosed as light and heavy chain deposition disease in department of Nephrology of the Second Xiangya Hospital, Central South University by renal biopsy. After treatment by oral prednisone, melphalan and thalidomide, the patient's proteinuria and serum creatinine decreased. The retrospective analysis of this case provides a guide for doctors to understand the light and heavy chain deposition disease. Early diagnosis and treatment could improve the prognosis.
Antibodies, Monoclonal ; adverse effects ; Basement Membrane ; physiopathology ; Biopsy ; Creatinine ; blood ; Heavy Chain Disease ; diagnosis ; drug therapy ; Humans ; Immunoglobulin Light Chains ; Kidney ; physiopathology ; Male ; Proteinuria

BACKGROUNDThe objective of this study was to analyze the trend in the publication of systematic reviews on hip fractures through a bibliometric approach.

METHODSLiterature including systematic reviews or meta-analyses on hip fractures was searched from the ISI Web of Science citation database. The search results were analyzed in terms of geographical authorship and frequency of citation by country, institution, author, and periodical distribution.

RESULTSA total of 654 published systematic reviews from 1995 to 2013 in 48 countries or regions were retrieved. The United States (171) was the predominant country in terms of the number of total publications, followed by the United Kingdom (149), Canada (120), Australia (76), and China (54). The number of systematic reviews significantly increased during the last 6 years, especially in China. The production ranking changed in 2012, at which time the United States and China were the leaders in the yearly production of systematic reviews on hip fractures. The amount of literature (27 publications) from China contributed almost one-quarter of the total literature (109 publications) in 2012. However, the average number of citations of each article from China was still low (6.70), while the highest number of citations of each article was from Sweden (193.36). The references were published in 239 different journals, with 15 journals contributing to 41.3% of the systematic reviews on hip fractures. The two journals that contributed the most were Osteoporosis International (10.6%) and the Cochrane Database of Systematic Reviews (7.6%). The predominant institution in terms of the number of publications was McMaster University (36) in Canada.

CONCLUSIONSThe best evidence in the field of hip fractures has attracted increasing attention. Systematic reviews on hip fractures from China have been increasingly more frequent during the past 6 years, particularly in 2012.