Objective:To investigate the rational use of antiplatelet drugs and provide references for clinical utilization. Method:The sales amount,defined daily dose(DDDS) and daily expense(DDDc) of antiplatelet drugs in senile wards of our hospital were collected and analyzed,and other kinds of drugs which had drug interaction with aspirin were monitored by the Prescription Automatic Screening System(PASS) during 2007-2008.Result:Clopidogrel Hydrogen Sulphate Tablet was No.1 of all DDDs and Alprostadil Fat Emulsiom Injection was the most expensive of all the antiplatelet drugs,and the DDDs of aspirin was lower only than that of Clopidogrel Hydrogen;moreover,there were some problems in the clinical use of aspirin.Conclusion:The antiplatelet drug utilization in the senile wards almost meets with the guidelines and develops towards the direction to use new drugs with good action and few side-effects,but needs further standardization.

Objective:To analyze the clinical outcome and feasibility for patients who underwent total parathyroidectomy without autotransplantation (TPTX) for secondary hyperparathyroidism (SHPT).Methods:From April 2012 to December 2015,220 SHPT patients underwent TPTX in the department of Breast and Thyroid Surgery of China-Japan Friendship Hospital.The clinical data and effect were assessed retrospectively.Results:All the 220 patients were on permanent dialysis with mean duration of dialysis (7.93 ± 3.75) years.A durable reduction in mean PTH,Ca and P were observed after TPTX (P＜0.01).The mean hospital stay was (7.8 ± 2.8) days.TPTX produced a rapid improvement in clinical symptoms.Incidence of hypocalcemia was 73.46％.Severe complications such as recurrent laryngeal nerve palsy or inactive dynamic osteopathia,haven't been observed postoperatively.The rate of persistent status (PTH≥300 pg/mL) was 9.1％.One (0.45％) died of infectious shock perioperatively.Conclusions:TPTX was a safe and feasible surgical procedure for patients with SHPT.It was worth of being applied.Not missing the parathyroid during operation was the key point for successful TPTX.Intensive monitoring and maintaining stable normocalcemia were the key point to reduce complication.

A) in COL1A1 gene resulting in OI in a Chinese family. The detailed molecular and clinical features will be useful for extending the evidence for genetic and phenotypic heterogeneity in OI and exploring the phenotype-genotype correlations in OI.

Objective To investigate the expression of syndecan-1 (SDC1) in glioma cells and the effects of synde?can-1 knockdown on the proliferation and invasion of A172 cells. Methods The expression of syndecan-1 in glioma cells was analyzed using quantitative Real-time PCR and Western blotting. A172 cells were transfected with lentiviral vector carrying SDC1 shRNA to establish a stable SDC1-silencing cell line. The cell proliferation was analyzed by MTT assay. Trypan blue exclusion assay and flow cytometry, and Transwell assays were performed to measure the migration and invasion abilities, respectively. The mRNA and protein and expression levels of SDC1, Proliferation Cell Nuclear An?tigen (PCNA) and Matrix Metalloproteinase 9 (MMP-9) were detected by using qRT-PCR and Western blotting. Results The expression levels of SDC1 were significantly different in different glioma cell lines. The stable SDC1-silencing cell line was successfully established, in which the mRNA and protein expression levels of SDC1 were significantly decreased (P<0.05). SDC1 knockdown significantly reduced the cell proliferation, migration(58.40±5.24 vs. 255.8±16.09、226.5± 22.84,F=126.4,P<0.05)and invasion(61.67 ± 16.26 vs. 233.70 ± 17.24、244.30 ± 28.15,F=69.87,P<0.05)compared with either control group or blank group. SDC1 knockdown also significantly decreased the mRNA and protein expression levels of PCNA and MMP-9 (P<0.05). Conclusion:SDC1 knockdown suppresses the capacities of proliferation, invasion and migration of glioma A172 cell, implying that SDC1 may serve as a novel target in the biotherapy of glioma.

Objective To evaluate the efficacy and safety of local infiltration analgesia in the multimodal analgesia protocol.Methods Sixty patients who were scheduled to undergo TKA were randomly divided two groups:local infiltration analgesia (LIA) group (n=30) or the non-local infiltration analgesia (N-LIA) group (n=30).All patients were given Celecoxib 200 mg bid,3 days preoperative,and a single-injection femoral nerve block (SFNB) half an hour before the surgery (ropivacaine 3.3 g/L,30 ml).The LIA group was given local infiltration analgesia with ropivacaine (2.5 g/L,60 ml) and 0.1 mg epinephrine before suture the operative incision.The N-LIA group didn't do the LIA.Both of the two groups didn't use the patient controlled analgesia.The VAS scores,the knee joint range of motion,the muscle strength of quadriceps femoris and the side effects and complications were recorded.Results The VAS scores were lower in LIA group than in the N-LIA group,these scores at 2 h to 48 h after surgery at rest and after 24 h at motion had statistical significance.The range of motion and the muscular strength of quadriceps femoris in the LIA group were better than in the N-LIA group.In the LIA group the use of opioids was less and the side effects were lower.The average length of hospital stay after the operation was shorter in the LIA group than the N-LIA group.Conclusion This multimodal perioperative analgesia protocol that include SFNB and LIA offered improved pain control and minimal side effects to patients undergoing TKA.

Objective To report a familial dentinogenesis imperfecta type Ⅱ (DGI type Ⅱ) with a novel splicing mutation in DSPP (dentin sialophosphoprotein) gene.Methods Based on the result of linkage analysis performed previously to map the candidate gene DSPP in the family, the promoter,the first four exons and exon-intron boundaries of DSPP were directly sequenced for the members of the DGI type Ⅱ family. Denaturing high performance liquid chromatography (DHPLC) analysis was performed to confirm the results of sequencing.Results A novel splicing mutation of 23 bp deletion in intron 2 of DSPP gene was identified by DNA sequence analysis. The mutation changed acceptor site sequence from CAG to AAG, and might result in functional abolition of possible branch point site in intron 2. DHPLC result was consistent with that of sequencing. The mutation may be identified in all affected individuals, but not found in normal members of the family and 50 controls.Conclusion These results suggest the deleted mutation of DSPP gene causes DGI type Ⅱ in the family. The mutation has not been reported before.

This study shows the case of a patient with peroneus brevis tendon rupture in ankle fracture. The patient com-plained of swelling, pain and activity limitation in her right ankle caused by sprain. She was diagnosed with ankle fracture, supina-tion-adduction (Lauge-Hansen typing) by medical history, physical examination and imaging. The peroneus brevis tendon was not-ed complete ruptured when suturing the incision after ORIF, which was then repaired by "8" shaped suture. Based on literature re-view, the injury mechanism of the case may be because of overload inversion force toward to lateral inferior from the fracture of fib-ula on the peroneus brevis tendon. Additional attention should be paid to patients who suffered from an supination-adduction ankle fracture for whether peroneus brevis tendon tears before and during surgery.

With the increasing prevalence of total knee arthroplasty (TKA), there is a corresponding rise in the number of patients requiring revision of total knee arthroplasty (R-TKA) for various reasons. R-TKA presents several complex challenges, with severe bone defect reconstruction being a critical obstacle to securing favorable long-term outcomes. Recently, the approach to managing bone defects has seen significant advancements, with a range of techniques proposed contingent on the defect's size and location. Severe bone defects require reconstruction with autologous or allogeneic bone grafts or metal fillers. However, bone grafts have their usage constrained by limited availability, risks of resorption and collapse, and the potential for disease transmission. Consequently, metal fillers have received widespread attention in practical applications due to their advantages, such as comprehensive source, customizability, and safety. The advantages of metal augment are that they provide immediate support without reinforcement and are not subject to necrosis and resorptive collapse. However, the difference in elastic modulus between metal and bone may lead to stress shielding and increase the risk of potential bone loss. Both Cone and Sleeve can achieve biological fixation of metaphyseal bone; however, in cases of periprosthetic infections, it is generally difficult to remove them easily due to the prosthetic bone in-growth and osseointegration. This study aims to provide a comprehensive review of the use of metal fillers to reconstruct bone defects during R-TKA. It is intended to aid orthopedic surgeons in understanding the spectrum of reconstructive possibilities and provide high-performance revision strategies for their patients.

Objective To investigate the effect of lumboperitoneal (L-P) shunt and ventriculoperitoneal(V-P) shunt for trea-ting the patients with communicating hydrocephalus .Methods The databases of PubMed ,Web of Science ,Scopuss ,Karge , EBSCO+MEDLINE ,OVID ,EMBASE ,CNKI ,CBM disc databases ,Wanfang databases ,Weipu databases were retrieved by com-puter .The relevant literatures about L-P shunt and V-P shunt for treating communicating hydrocephalus included in these databases during 1990-2016 were collected and performed the meta analysis by using the STATA 12 .0 software .Results The success rate of L-P shunt in treating communicating hydrocephalus was apparently higher than that of V-P shunt(P<0 .05) .Moreover ,postopera-tive infection rate ,obstruction rate of shunt system and total postoperative complications rate in L-P shunt were apparently lower than those of V-P shunt(P<0 .05) ,However ,there was no statistical difference in shunt poor rate between L-P shunt and V-P shunt(P>0 .05) .Conclusion L-P shunt is worth recommending .But due to lower quality of the evidences ,it is needed more high quality primary studies to remedy the insufficiency of the study .

Objective To investigate the relationship between Toxoplasma gondii (T.gondii) infection and metabolic syndrome (MS).Methods A total of 20 577 patients who received serum test of anti-T.gondii IgG antibody in the National Health and Nutrition Examination Survey ( NHANES) of the United States from 2009 to 2014 were collected to analyze the clinical features of anti-T.gondii IgG antibody positive patients , and to compare metabolic related indicators in the antibody IgG positive and negative groups .The independent sample t-test, chi-square test, and logistic regression analysis were used to explore the risk factors of MS . Results A total of 2 746 participants were positive for the T.gondii antibody (13.34%), with a higher prevalence of male (14.44%vs 12.27%, χ2 ＝15.99, P＜0.01).Meanwhile, the prevalence of T.gondii increased with age and body mass index (BMI) (χ2 ＝979.98 and 50.85,respectively, both P＜0.01).Among the 2 191 patients with MS, 449 (20.49%) patients were positive for T.gondii.While 2 297 (12.49%) patients were anti-T.gondii positive in 18 386 non-MS patients.The difference was statistically significant (χ2 ＝78.504, P＜0.01).Age (t＝-37.37), BMI (t＝-4.28), glycosylated hemoglobin (t＝-11.81), fasting blood glucose (t＝-9.38), triacylglycerol (t＝-6.32), cholesterol (t＝-7.16), serum uric acid (t＝-5.25) and serum creatinine (t＝-7.69) in the seropositive group were all higher than those in the seronegative group (all P＜0.01).After adjusting for age and gender , the prevalence of T.gondii was an independent risk factor for MS (odds ratio [OR]＝1.147,P＝0.023).Conclusions BMI, blood lipids, blood uric acid and blood glucose are significantly increased in patients with T.gondii infection.T.gondii infection is an independent risk factor for MS.