Objective To develop and charaterize a series of Poloxamer-and Carbopol-based in situ gel for ophthalmic use as to enhance the ability of drug to retain in eyes and delay drug release.Methods The gel was prepared using Poloxamer 407/188 and Carbopol 974P as gelling agent and viscosity enhancer,respectively.Rheological characteristics were evaluated and behaviour of drug release in vitro was investigated by modified Franz diffusion cells.Results The rheological study indicated that the gel was physically entangled polymer solutions at 20 ℃ and then converted into a network structure with secondary bonds at 35 ℃.The gel released the drug molecules slowly in 4 h.The best fit model was Higuchi matrix model(r=0.992 3).Formulations consisting of Poloxamer 188 and Carbopol 974P were proved to be able to decrease the drug release speed efficiently.The impact on elastic modulus G" of the gel caused by those two were different.Conclusion An in situ gel with suitable sol-gel transition temperature and satisfactory release pattern could be achieved by adjusting the ratio of Poloxamer 407 to Poloxamer 188.The developed formulations have the ability to prolong the ocular residence time,which suggests it may be a new durg delivery system with bright future.

Objective:To evaluate the clinical correlation between the CardioChek PA analyzer (CCPA)and a clinical laboratory reference method to use for screening program purposes.Methods:Fasting blood samples were collected on 325 patients (age:23 -86 years).One venous sample was col-lected using a serum tube for the evaluation on a Beckman reference analyzer.A second venous sample was collected in a lithium heparin tube and was evaluated on the CCPA analyzer.Linear regression analy-ses and Bland-Altman method were performed for each measured analyte:total cholesterol (TC),high density lipoprotein-cholesterol (HDL-C),triglycerides (TG)and low density lipoprotein-cholesterol (LDL-C).Results:Our results demonstrated a good clinical agreement for TC,HDL-C,TG and LDL-C (97.0%,92.9%,92.4% and 83.7%)in comparison with the CCPA to the reference analyzer.The correlation coefficients were 0.875,0.81 3,0.91 0,0.864,respectively.P values all <0.001 .There was no significant difference in the detection rate of hyperlipidemia in TC,HDL-C and LDL-C.Conclu-sion:We have identified the pre-analytic phase as an important step to guarantee the quality of results and indicated that the CCPA is a reliable lipid point-of-care testing system that can be used for the appli-cation of clinical screening anywhere.

Objective: To preliminarily explore the clinical characteristics and gender difference of patients with variant angina (VA) in China. Methods: A total of 312 patients with spontaneous attack of VA admitted in our hospital from 2003-01 to 2009-12 without stimulation test were retrospectively studied. The clinical features were compared between male and female patients to reveal the similarities and differences of VA by genders. Results: The predilection of VA was in male gender (274/312, 87.8%), the common risk factors including smoking, hypertension and hyperlipidemia; 55/312 (17.6%) patients had allergy history. There were 59/312 (18.9%) patients combining arrhythmia while VA attack; coronary angiography (CAG) found that 155/283 (54.8%) patients were with ifxed coronary stenosis and 22/312 (7.1%) combining coronary myocardial bridge. Nitrates, calcium antagonist and stent implantation may effectively control VA attack. Compared with male, female patients had the lower ratio of smokers (10.5% vs 78.8%),P<0.01, higher ratios of family history of coronary artery disease (CAD) (31.6% vs 11.3%),P<0.01, ventricular tachycardia (13.2% vs 3.6%)P<0.05 and ventricular ifbrillation (7.9% vs 1.8%),P<0.05. Conclusion: VA is a cardiac ischemia caused by coronary artery spasm with high incidence for combining arrhythmia, without in time treatment it may incur myocardial infarction even sudden death. VA patients should receive routine CAG and stent implantation according to the severity of stenosis. Female patients were with less smokers while higher ratios in family history of CAD, ventricular tachycardia and ventricular ifbrillation.

Objective To explore the feasibility of the application of non fasting blood lipid in the hospitalized population.Methods Self-control study was used.608 patients(aged 20~86 years old) were enrolled from April 2015 to October 2016 in lipid center of FuWai hospital.Fasting sample and non-fasting sample(1~4 h after breakfast) were collected from every patient and lipid profile including TG (triglyceride), TC (total cholesterol), HDL-C (high density lipoprotein cholesterol) and LDL-C (low density lipoprotein cholesterol) were measured in clinical laboratory.The results of two tests were compared using the Wilcoxon signed-rank test.Results The differences between non-fasting and fasting lipid test were +0.47 mmol/l (+30%) for TG,-0.03 mmol/l (-2.8%) for HDL-C,-0.09 mmol/l (-3%) for LDL-C and-0.24 mmol/l (-8.7%) for calculated LDL-C (P<0.001 respectively).The differenceswere +0.01 mmol/l for TC and +0.02 mmol/l for non-HDL-C,therefore no statistical difference was observed.When the TG level was stratified,the level of non-fasting LDL-C using directing test method was not significantly different between TG> 4.5 mmol/L and the whole (0.07 vs.0.09),but the level of non-fasting LDL-C using formula method wassignificantly different between TG> 4.5 mmol/L and the whole (0.66 Vs.0.24),andthe drops were 34.9% vs.8.7%.Conclusion Non-fasting lipid test could be an effective routine method for lipid evaluation in the hospitalized population.

Objective: To explore the safety and efficacy of lipoprotein apheresis (LA) in treating the patients with familial hypercholesterolemia (FH).
Methods: A total of 12 FH patients treated in our hospital from 2015-02 to 2016-10 were retrospectively studied. Based on intensive cholesterol lowering therapy with rosuvastatin (10-20) mg Qd and Ezetimibe 10 mg Qd, the patients received LA by double ifltration plasma pheresis (DFPP) via bilateral elbow central vein or femoral vein. The changes of lipid level were compared at before and after LA treatment.
Results: For pre- and immediately after LA treatment, the average total cholesterol (TC) was (9.42±3.65) mmol/L vs (2.84±0.83) mmol/L, low density lipoprotein cholesterol (LDL-C) was (7.31±3.46) mmol/L vs (1.95±0.82) mmol/L; at 1, 3, 7 and 30 days after treatment, TC and LDL-C levels showed increasing trend, while they were still lower than they were before treatment, allP<0.01. For pre- and immediately, 1 day, 3 days after treatment, the average HDL-C level was (0.96±0.31) mmol/L, (0.63±0.17) mmol/L, (0.56±0.15) mmol/L and (0.68±0.22) mmol/L respectively,P<0.05-0.01. For pre- and immediately after LA treatment, the average TG level was (1.90±0.86) mmol/L vs (0.88±0.38) mmol/L,P<0.05. Only 1 patient had the symptoms of hypotension, nausea and sweat, the patient was relieved by expectant treatment.
Conclusion: LA therapy may decrease blood levels of TC and LDL-C at short term in FH patients with good tolerance;even TC and LDL-C could slowly increase after treatment, while combining with lipid lowering therapy, it has been a safe and effective method for treating relevant patients.

Objective To investigate the incidence, imaging and clinical characteristics in elderly patients with coronary artery ectasia (CAE). Methods A retrospective analysis was conducted on patients with CAE who underwent coronary angiography between January 2006 and December 2012. According to age, the enrolled patients were divided into two groups (elderly group, age≥ 65 years; non-elderly group, age < 65 years). The clinical feature, imaging characteristics and the 5-year survival rate of the two groups were compared.Results The preva-lence of CAE in elderly patients was 0.33%. Patients in elderly group were found to have significantly higher proportion of female (30.1%vs. 10.1%,P< 0.001), three-vessel disease (60.5%vs. 45.2%,P = 0.003) and localized ectasia (55.0%vs. 40.2%,P = 0.003). In addition, body mass index (20.90 ± 2.71 kg/m2vs. 22.31 ± 2.98 kg/m2,P < 0.001) and percentage of current smokers (45.0%vs. 64.6%,P < 0.001) were significantly lower in elderly group. Cumulative survival curves demonstrated reduced 5-year cumulative survival at the follow-up in the elderly group compared with the non-elderly group (88.0%vs. 96.0%,P = 0.002). But the 5-year event free survival rate failed to show a significant difference between the two groups (31.0%vs. 35.0%,P= 0.311).ConclusionThe prevalence of CAE in elderly patients was 0.33%, which was about 1/3 of the entire numbers of CAE patients. There were significant differences between the elderly and the non-elderly patients with CAE in terms of coronary artery disease risk factors and coronary artery ectatic characteristics. CAE might be asso-ciated with increased mortality risk in the elderly.

Objective To analyze the risk factors associated with periprosthetic femoral fracture following hemiarthroplasty (HA) for displaced femoral neck fracture in aged patients.Methods From January 2013 to June 2016,120 patients over 80 years old were treated by HA for displaced femoral neck fractures.They were 45 males and 75 females,with an average age of 85.2 years (from 80 to 97 years).Their fractures were Garden type Ⅲ (72 cases) and Garden type Ⅳ (48 cases).The time from injury to operation averaged 5.1 days.The patients were divided into a fracture group and a non-fracture group according to the presence or absence of the periprosthetic fracture.The general data of the 2 groups were compared;multivariate logistic regression analyses were done to indentify the influencing factors associated with periprosthetic femoral fracture.Results The 120 patients obtained a mean follow-up of 26.1 months (from 13 to 48 months).Periprosthetic femoral fracture occurred in 11 cases,giving an overall incidence of 9.2％ (11/120).Compared with the non-fracture group,the average age was significantly older,the incidence of past fractures was significantly higher,significantly more types of uncemented stem were used,and American Society of Anesthesiologists (ASA) grading was significantly more severe for the fracture group (P ＜ 0.05).There were no significant differences between the 2 groups concerning the general data (P ＞ 0.05).Multivariate Logistic regression analyses revealed that age [OR =1.268,95％ CI (1.059,1.517),P =0.010] and type ofuncemented stem [OR =0.072,95％ CI (0.008,0.625),P =0.017] were independent risk factors for periprosthetic fracture.Conclusions The incidence of periprosthetic femoral fracture in the elderly patients may be high following HA for femoral neck fractures.Since age and uncemented stem may be independent risk factors for periprosthetic femoral fracture,surgeons should pay enough attention to them in clinic.

Objective: To study the relationship between ABO blood type and spontaneous re-canalization (SR) in patients with acute myocardial infarction (AMI). Methods: A total of 1209 consecutive AMI patients were enrolled. Based on TIMI grade, the patients were divided into 2 groups: Non-SR group, the patients with TIMI grade 0-1,n=442 and SR group, the patients with TIMI grade 2-3,n=767. The relationship between ABO blood type and SR was investigated. Results: Compared with Non-SR group, SR group had more patients with blood type O (32.3% vs 24.7%) and less blood type A (31.7% vs 24.9%). Meanwhile, we found that a lower cholesterol level was related to patients with O blood type and SR occurrence, bothP<0.05. Multi regression analysis indicated that with adjusted age, gender, BMI, hypertension, diabetes, smoking, LDL-C and C-reactive protein, ESR, fibrinogen, D-dimmer, endothelial cardiac function, blood type O may independently predict SR occurrence in AMI patients (OR=1.49, 95% CI 1.10-2.05), while blood type A may have disadvantage for SR (OR=0.65, 95% CI 0.48-0.80). Conclusion: ABO blood type has been related to SR in AMI patients, blood type O is in favor of SR, while blood type A has disadvantage for SR occurrence.

Objective To investigate the effect of intraoperative dripping of intravenous tranexamic acid (TXA) on the perioperative blood loss in elderly patients undergoing hip arthroplasty for femoral neck fracture.Methods From January 2016 to August 2017,118 elderly patients with femoral neck fracture were treated with hip arthroplasty at Department of Orthopaedics,China-Japan Friendship Hospital.They were 45 males and 73 females,with an average age of 77.1 years.Of them,60 (TXA group) were subjected to intravenous TXA dripping over 10 minutes by 2 doses (15 mg/kg TXA dissolved in 100 mL of saline) with the first dose before incision and the second one at wound closure;58 (control group) were subjected to intravenous administration of 100 mL of saline solution in a similar fashion.Blood routine tests were carried out one day before operation,and the first and third days after operation.The transfusion rate and volume,and surgical blood loss were recorded.The total blood loss on postoperative 1-day and 3-day were calculated according to hemoglobin balance method.The 2 groups were compared in terms of blood loss and complications.Results The blood transfusion rate (21.7％),blood transfusion volume (310.8 ± 85.7 mL),surgical blood loss (424.3 ± 87.6 mL),total blood loss on postoperative 1-day (1,284.6 ±288.7 mL) and total blood loss on postoperative 3-day (1,501.2 ± 337.1 mL) in the TXA group were all significantly lower than those in the control group (41.4％,379.8 ± 110.2 mL,526.7 ± 113.8 mL,1,534.8 ± 279.2 mL and 1,887.4 ± 431.8 mL,respectively) (P ＜ 0.05).There was no significant difference between the 2 groups in postoperative complications (P ＞ 0.05).Conclusion In elderly patients undergoing hip arthroplasty for femoral neck fracture,intravenous TXA administration may lower transfusion rate,reduce transfusion volume,and decrease surgical blood loss and postoperative total blood loss without increasing the risks of surgery-related complications like thrombosis.

Objective:To explore the incidence and morphology of the posterolateral fracture fragment affecting the fibular notch in posterior pilon fracture.Methods:A retrospective analysis was conducted of the CT and clinical data of the 31 patients with posterior pilon fracture who had been treated at Department of Orthopaedic, China-Japan Friendship Hospital from May 2013 to May 2018. They were 17 men and 14 women, aged from 20 to 68 years (average, 42 years). The injury affected the left side in 13 cases and the right side in 18 ones. The incidence of the posterolateral fracture fragments affecting the fibular notch was counted. The morphologic indexes of the fragments were measured like axial angle of their fracture line, fragment area, fragment height, and sagittal angle of their fracture line.Results:A posterolateral fracture fragment affecting the fibular notch was found in all the 31 posterior pilon fractures, giving an incidence of 100% in the posterior pilon fracture. The fracture line of the fragments tended to be in the coronal plane. The axial angle of the fracture line was 20.25°±9.48°; the ratio of the fragment area to the distal tibial articular area was 15.78%±6.75%; the fragment height was 36.59 mm ± 10.70 mm; the sagittal angle of the fracture line was 18.37°±5.45°.Conclusions:A posterolateral fracture fragment affecting the fibular notch can be found in all the posterior pilon fractures. It does not affect a large articular area and its fracture line is usually located in the coronal plane. These data may help choose appropriate surgical approach and internal fixation.