Objective To Compare postoperative complications between patients with varicose veins of the lower limbs treated with foam sclerotherapy or endovenous laser.Method From 2011 to 2015,simple varicosis of great saphenous vein patients (grade C3-6) in 2 542 cases,3 468 limbs were divided into 2 groups.Combined with high ligation of great saphenous vein plus stripping,foam sclerotherapy group (1 355 cases) underwent calf foam sclerotherapy (1％ polidocanol),endovenous laser group (1 187 cases) underwent endovenous laser therapy.All postoperative patients were treated with stretch socks for 3 months.Postoperative pain (calf),deep vein thrombosis,pulmonary embolism,superficial thrombophlebitis,saphenous nerve injury,ecchymoma,migraine,allergic dermatitis,pigmentation in 2 groups were compared.Result During the follow-up,28 cases in foam sclerotherapy group had saphenous nerve injury (2％),1 071 (79.1％) cases had subcutaneous ecchymosis,613 cases (51.6％) in endovenous laser group had saphenous nerve injury,979 cases (82.5％) had subcutaneous ecchymosis,8 cases (1.0％) had skin burns (x2 =824.660,4.786,9.161,P ＜ 0.05).Endovenous laser group (23.8％) was significantly better than that of foam sclerotherapy group (30.8％) in pigmentation (x2 =15.243,P ＜0.05).Conclusion Treatment of varicose veins of the lower leg with foam sclerotherapy has less postoperative complications compared with endovenous laser.

OBJECTIVE: To compare the efficacy of metformin plus megestrol acetate (MA) with that of MA alone for treating endometrial atypical hyperplasia (EAH). METHODS: This pilot study included 16 EAH patients who met at least one metabolic syndrome (MS) criterion and received either adjunctive metformin plus MA (MET group) or MA monotherapy (MA group). Each patient in the MA group received 160 mg of MA daily, whereas patients in the MET group received the same dose of MA plus 0.5 g of metformin thrice daily. Treatment response was assessed by histological examination of dilation and curettage specimens obtained after 12 weeks of therapy. RESULTS: Each group had eight patients, and half of the patients in each group were diagnosed with MS. The complete response (CR) rate was 75% (6/8) in the MET group and 25% (2/8) in the MA group (p=0.105). Complications of MS did not affect the response rates in either group. In the MET group, 75% (3/4) of the patients had CR in the presence or absence of MS. In the MA group, 50% (2/4) of the patients with MS had CR, whereas no patient without MS had CR. No irreversible toxicities were observed. CONCLUSION: Metformin plus MA may be a potential alternative therapy for treating EAH, and the MS status of patients may have no effect on the efficacy of metformin plus MA therapy.
Adult ; Antineoplastic Agents, Hormonal/*therapeutic use ; Drug Therapy, Combination ; Endometrial Hyperplasia/complications/*drug therapy/metabolism ; Female ; Humans ; Hypoglycemic Agents/*therapeutic use ; Megestrol Acetate/*therapeutic use ; Metabolic Syndrome X/complications/metabolism ; Metformin/*therapeutic use ; Pilot Projects ; Receptors, Estrogen/metabolism ; Receptors, Progesterone/metabolism ; Single-Blind Method ; Treatment Outcome

Objective To explore the predictive significance of platelet changes on deep venous thrombosis of the lower limbs after total knee replacement,and to guide the early clinical prediction and prevent the occurrence of thrombotic events.Methods A retrospective study was conducted of the 50 patients who had been treated by total knee arthroplasty for degenerative knee osteoarthropathy from January 2016 to June 2018 in the Department of Orthopedics and Traumaology,Xi'an Jiangtong University Medical College Red Cross Hospital.There were 10 males and 40 females,aged from 47 to 80 years (average age 65.1 years).According to the results of B ultrasound examination of the lower extremities,the patients were divided into the non embolic group (24 cases) and the embolic group (26 cases).The platelet counts and hemoglobin levels of the two groups were recorded before and after operation,and their respective differences were calculated.The difference of hemoglobin difference between the two groups was analyzed.At the same time,the difference of platelet count and total knee joint were examined.Whether the deep venous thrombosis of the lower extremity after replacement was statistically significant.If there was no statistical difference in the difference in hemoglobin between the two groups,and the difference in platelet count was statistically significant,the ROC curve was made to determine the optimal screening point.If obeying the normal distribution and the homogeneity of the variance,an independent sample t test was performed on the platelet count difference and the hemoglobin amount difference between the two groups,and the dose data in accordance with the normal distribution was expressed as (Mean ±SD).Results The difference of platelet count was (30.4 ± 14.8) ×109/L in thrombosis group and (53.5 ± 15.2) × 109/L in thrombosis group.The difference of platelet count between the two groups had statistical significance (P ＜ 0.001).The best screening point of platelet count difference was 34.0 × 109/L.The difference of hemoglobin count between thrombosis group and thrombosis group was (20.8 ± 9.3) g/L and (24.0 ± 10.7) g/L,there was no significant difference in hemoglobin between the two groups (P ＞ 0.05).Conclusions Preoperative and postoperative platelet count difference can effectively predict the incidence of lower extremity deep venous thrombosis after total knee arthroplasty.When the platelet count difference before surgery ≥34.0 × 109/L,early prevention of deep venous thrombosis should be avoided.The formation of the occurrence.

Objective To analyze the management and countermeasures of adverse nursing events in a municipal tertiary hospital in Guangxi Zhuang Autonomous Region.Methods The adverse nursing events in 2023 in a municipal tertiary hospital in Guangxi were retrospectively analyzed.Logistic regression analysis was utilized to identify the causes of these adverse events and propose suitable countermeasures.Results In 2023,a total of 121 adverse nursing events were recorded,with falls being the most prominent(42 cases,accounting for 34.71％),followed by drug extravasation,drug safety incidents and unplanned ex-tubation,accounting for 13.22％,9.92％,and 7.44％respectively.Logistic regression analysis revealed that factors such as age ≥70 years,coexisting diseases,Basel Index score ≤40,pain score ≥4,tube slip risk assessment ≥10,RASS sedation score ≥3,NGASR score ≥9,lost risk assessment score ≥ 7,GCS Coma Scale score ≤8,Stress Injury Assessment Scale score ≤10,and Morse score ≥45 were associated with the risk of adverse nursing events.In addition,inadequate awareness of nursing risks among nursing staff,ineffective patient health education methods,and non-compliance to nursing protocols were identified as primary causes of adverse nursing events.Conclusion Advanced age,combined with other diseases,and hospitali-zation scale assessment results are critical factors for adverse nursing events.Lack of nursing responsibility and risk awareness among nursing staff,inadequate system implementation,and irregular operations can increase the risk.Hospitals should optimize management systems and work processes,enhance nursing staff training,and develop targeted preventive measures for adverse nursing events to improve the quality of nursing management and reduce the risk of adverse nursing events.

Objective:To explore the effect of moxibustion pretreatment on bone marrow suppression in cancer patients after chemotherapy, so as to provide a basis for clinical nursing.Methods:From May 2019 to May 2020, we selected 70 cancer patients who met the criteria in the Oncology Department of a ClassⅢ Grade A hospital in Xuzhou City, Jiangsu Province by convenient sampling. There were 65 patients who finally completed the trial including moxibustion pretreatment group ( n=20) , moxibustion group ( n=22) , and control group ( n=23) . All three groups received regular chemotherapy. Patients in moxibustion pretreatment group received moxibustion 7 days before the start of chemotherapy, once a day, for 14 days; patients in moxibustion group were treated with moxibustion at the beginning of chemotherapy, once a day, for 7 days; control group carried out conventional chemotherapy. We compared the white blood cell count, neutrophil count, incidence and degree of bone marrow suppression, and the use of recombinant human granulocyte colony stimulating factor among the three groups. Results:The white blood cell and neutrophil counts of the three groups were compared between the groups and at different times, and the differences were statistically significant ( P<0.05) . The incidences of bone marrow suppression on the seventh and fourteenth day after chemotherapy of the three groups of patients were compared between the groups and at different times with statistical differences ( Wald χ2groups=6.628, P=0.036; Wald χ2times=43.018, P<0.001) . A total of 7, 14 days after chemotherapy, there were statistical differences in the use of recombinant human granulocyte colony stimulating factor in patients among the three groups ( P<0.05) . Conclusions:Moxibustion pretreatment can stabilize the white blood cell and neutrophil counts of cancer patients after chemotherapy, reduce the incidence of bone marrow suppression, the degree of bone marrow suppression as well as the use of recombinant human granulocyte colony stimulating factor.

Background: Bovine papillomatosis is a type of proliferative tumor disease of skin and mucosae caused by bovine papillomavirus (BPV). As a transboundary and emerging disease in cattle, it poses a potential threat to the dairy industry. Objectives: The aim of this study is to detect and clarify the genetic diversity of BPV circulating in dairy cows in Xinjiang, China. Methods: 122 papilloma skin lesions from 8 intensive dairy farms located in different regions of Xinjiang, China were detected by polymerase chain reaction. The genetic evolution relationships of various types of BPVs were analyzed by examining this phylogenetic tree. Results: Ten genotypes of BPV (BPV1, BPV2, BPV3, BPV6, BPV7, BPV8, BPV10, BPV11, BPV13, and BPV14) were detected and identified in dairy cows. These were the first reported detections of BPV13 and BPV14 in Xinjiang, Mixed infections were detected, and there were geographical differences in the distribution of the BPV genotypes. Notably, the BPV infection rate among young cattle (< 1-year-old) developed from the same supply of frozen sperm was higher than that of the other young cows naturally raised under the same environmental conditions. Conclusions Genotyping based on the L1 gene of BPV showed that BPVs circulating in Xinjiang China displayed substantial genetic diversity. This study provided valuable data at the molecular epidemiology level, which is conducive to developing deep insights into the genetic diversity and pathogenic characteristics of BPVs in dairy cows.

Background: Bovine papillomatosis is a type of proliferative tumor disease of skin and mucosae caused by bovine papillomavirus (BPV). As a transboundary and emerging disease in cattle, it poses a potential threat to the dairy industry. Objectives: The aim of this study is to detect and clarify the genetic diversity of BPV circulating in dairy cows in Xinjiang, China. Methods: 122 papilloma skin lesions from 8 intensive dairy farms located in different regions of Xinjiang, China were detected by polymerase chain reaction. The genetic evolution relationships of various types of BPVs were analyzed by examining this phylogenetic tree. Results: Ten genotypes of BPV (BPV1, BPV2, BPV3, BPV6, BPV7, BPV8, BPV10, BPV11, BPV13, and BPV14) were detected and identified in dairy cows. These were the first reported detections of BPV13 and BPV14 in Xinjiang, Mixed infections were detected, and there were geographical differences in the distribution of the BPV genotypes. Notably, the BPV infection rate among young cattle (< 1-year-old) developed from the same supply of frozen sperm was higher than that of the other young cows naturally raised under the same environmental conditions. Conclusions Genotyping based on the L1 gene of BPV showed that BPVs circulating in Xinjiang China displayed substantial genetic diversity. This study provided valuable data at the molecular epidemiology level, which is conducive to developing deep insights into the genetic diversity and pathogenic characteristics of BPVs in dairy cows.

Cystatin, a cysteine protease inhibitor found in many parasites, plays important roles in immune evasion. This study analyzed the molecular characteristics of a cystatin from Fasciola hepatica (FhCystatin) and expressed recombinant FhCystatin (rFhcystatin) to investigate the immune modulatory effects on lipopolysaccharide-induced proliferation, migration, cytokine secretion, nitric oxide (NO) production, and apoptosis in mouse macrophages. The FhCystatin gene encoded 116 amino acids and contained a conserved cystatin-like domain. rFhCystatin significantly inhibited the activity of cathepsin B. rFhCystatin bound to the surface of mouse RAW264.7 cells, significantly inhibited cell proliferation and promoted apoptosis. Moreover, rFhCystatin inhibited the expression of cellular nitric oxide, interleukin-6, and tumor necrosis factor-α, and promoted the expression of transforming growth factor-β and interleukin-10. These results showed that FhCystatin played an important role in regulating the activity of mouse macrophages. Our findings provide new insights into mechanisms underlying the immune evasion and contribute to the exploration of potential targets for the development of new drug to control F. hepatica infection.

Objective:To characterize the biomechanical performance of our self-designed novel blocking screws in the treatment of distal tibial fractures.Methods:Thirty artificial composite tibial bones were used to create models of unstable distal tibial fracture (AO type 43-A3) which were randomized into 3 even groups ( n=10) according to modes of fixation. Group A was subjected to fixation with intramedullary nails only with merely preset holes reserved for the blocking screws, group B to fixation with intramedullary nails plus conventional anteroposterior blocking screws, and group C to fixation with intramedullary nails plus novel lateral blocking screws. In all the 3 groups, a lateral bending stress test was conducted to record the maximum transversal displacement of the intramedullary nail, a fatigue test to observe the structural abnormality in the model and an axial stress test to record the maximum axial displacement of the intramedullary nail-bone structure. The 3 groups were compared in structural abnormality, the maximum transversal displacement of the intramedullary nail and the maximum axial displacement of the intramedullary nail-bone structure. Results:The lateral bending stress tests showed the maximum transversal displacements were (5.02±1.03) mm; (4.19±0.64) mm and (4.18±0.65) mm in groups A, B and C; compared with group A, the maximum transversal displacement decreased by 16.6%( P=0.027) in group B and decreased by 16.8%( P=0.025) in group C, showing significant differences but there was no significant difference in the maximum transversal displacement between groups B and C ( P=0.978). In the fatigue test, all models showed no structural abnormality under cyclic loading. In the axial stress test, the maximum axial displacements of the intramedullary nail-bone structure were, respectively, (5.69±0.75) mm, (5.31±0.61) mm and (5.51±0.65) mm in groups A, B and C, showing no statistically significant difference among the 3 groups ( P>0.05). Conclusion:Our self-designed novel blocking screws can be a new means in clinical application, because they are similar to conventional blocking screws in increasing the stability of nail-bone construct and other biomechanical performance.

Objective:To explore the efficacy of our novel reduction technique in the surgical treatment of complicated tibial plateau fractures.Methods:From May 2016 to September 2018, 50 fractures of tibial plateau (Schatzker types Ⅴ and Ⅵ) were treated at Department of Orthopaedics and Traumatology, Hong Hui Hospital. They were 34 males and 16 females, aged from 27 to 56 years (average, 42.3 years). They were divided into 2 groups according to the reduction techniques. In the group of novel reduction ( n=23), bone fragments were reduced one by one from the distal to the proximal until the compression fracture was reduced and fixated. In the conventional reduction group ( n=27), the articular surface was reduced first before fixation of articular fragments with distal ends of tibial fracture. The 2 groups were compared in terms of intraoperative bleeding, operation time, tibial plateau angle (TPA) on the knee anteroposterior X-ray film taken on the second day after operation, and rate of acceptable TPA (±5°). Results:There were no significant differences between the 2 groups in general preoperative data, showing comparability ( P>0.05). There were no significant differences between the 2 groups in either operation time (2.7 h ± 0.4 h versus 3.0 h ± 0.6 h) or intraoperative bleeding (215 mL ± 56 mL versus 221 mL ± 52 mL) ( P>0.05). The novel reduction group had a significantly higher rate of acceptable TPA [78.2% (18/23)] than the conventional reduction group [48.1%(13/27)]( P<0.05). Conclusion:In the surgical treatment of complicated tibial plateau fractures, compared with conventional reduction technique, our novel reduction technique can increase the rate of acceptable reduction but not operation time nor intraoperative bleeding.