Objective To compare the clinical effects between rivaroxaban and warfarin on preventing deep vein thrombosis (DVT) in elderly hip fracture patients with diabetes mellitus (DM) after operation. Methods One hundred and sixty-eight elderly hip fracture patients with DM were randomly divided into the observation group and the control group. The observation group (88 cases) were treated with rivaroxaban (10mg, po, qd) after surgery, and the control group were treated with warfarin and low molecular weight heparin calcium for 14 days. Respectively after 7, 14, 21 and 28 days, the color doppler ultrasonography was used to examination vein blood flow and the DVT of affected lamb. In addition, the levels of D-dimer and bleeding were observed during treatment. Results The incidence of DVT in observation group (2 cases, 2.23%) was significantly lower than that in control group (7 cases, 8.75%), and DVT of control group was happened on 7th day after surgery. In addition, the level of D-dimer on 7th day post-surgery in observation group significantly decreased, while it significantly decreased on 14th day post-surgery in control group (P<0.05). However, the incidence of bleeding events in observation was less than that in control group (P<0.05). Conclusion Rivaroxaban can be more effective compared with warfarin in preventing diabetes mellitus elderly hip fracture patients with postoperative DVT formation and significantly reduce the bleeding risk, with more safe and convenient.

Based on the analysis of the status quo of computer teaching,the present paper discusses the reform of teaching contents in the computer education in our college.

6cm,the recrudescenc rates when factors were male,mild or moderate malignant,stage of Dukes C,distance from tumor to anus 4～6cm were significantly higher(?2=4.53,P

ObjectiveTo compare and analyze conventional plan and inverse optimized plan in dosemetric of cervical cancer. MethodTwenty cases of cervical cancer treated with combination radical radiotherapy of EBT were selected,every case had two plans: one was conventional plan based A point prescription dose, the other was inverse optimized plan (IPSA, inverse planning with simulated annealing)based volume object dose.ResultsIPSA plans provided better values compared with the conventional plans in 90％ prescription dose volume V90[ (94 ± 15 )％ vs. (60 ± 17 )％], 100％ prescription dose volume V100[(90 ± 18)％ vs. (56 ± 14)％]and 100％ treatment volume dose D100[(54 ± 10)％ vs. (29 ±9)％](P ＜0.05),respectively. Meanwhile the organ at risk received lower dose volume. ConclusionsPlans generated using IPSA provide higher dose to the target volume but with lower dose to normal structure and less time. This study can help to guide the clinical application.

The inter-species differences of estradiol metabolism were investigated in human, Beagle dog and rat liver microsomes by comparing enzyme kinetics of parent drug and the formation of its major metabolites. The incubation systems of estradiol with liver microsomes of the three species were optimized in terms of estradiol concentration, microsomal protein content and incubation time. The concentrations of estradiol and its metabolites were measured by LC-MS/MS method. The t1/2, CLint, CLh, Km and Vmax of estradiol incubated with male human liver microsomes were 40.02 +/- 8.32 min, 41.39 +/- 6.57 mL x min(-1) x kg(-1), 13.81 +/- 12.36 mL x min(-1) x kg(-1), 26.8 +/- 6.99 micromol x L(-1) and 0.75 +/- 0.92 micromol x L(-1) x min(-1), respectively. The corresponding parameters of female human were 44.71 +/- 10.21 min, 29.85 +/- 8.97 mL x min(-1) x kg(-1), 0.01 +/- 0.68 mL x min(-1) x kg(-1), 44.2 +/- 7.73 micromol x L(-1) and 1.27 +/- 4.41 micromol x L(-1) x min(-1), that of male dog were 21 +/- 7.33 min, 165.53 +/- 29.33 mL x min(-1) xkg(-1), 26.01 +/- 8.39 mL x min(-1) x kg(-1), 19.5 +/- 7.34 micromol x L(-1) and 1.6 +/- 0.65 micromol x L(-1) x min(-1), that of female dog were 25.5 +/- 5.32 min, 135.11 +/- 42.34 mL x min(-1) x kg(-1), 0.24 +/- 3.18 mL x min(-1) x kg(-1), 8.33 +/- 6.32 micromol x L(-1) and 0.51 +/- 2.15 micromol x L(-1) x min(-1), that of male rat were 5.11 +/- 3.84 min, 485.63 +/- 36.52 mL x min(-1) x kg(-1), 49.57 +/- 15.29 mL x min(-1) x kg(-1), 62 +/- 13.74 micromol x L(-1) and 19.16 +/- 9.67 micromol x L(-1) x min(-1), and that of female rat were 7.0 +/- 3.69 min, 354.82 +/- 33.33 mL x min(-1) x kg(-1), 8.04 +/- 3.23 mL x min(-1) x kg(-1), 35.38 +/- 7.65 micromol x L(-1) and 8.39 +/- 4.91 micromol x L(-1) min(-1), respectively. There were nine metabolites detected from all the three species, but the relative amounts of the metabolites generated were different in three species. The results indicted that the major phase I metabolic pathway of estradiol was similar in the liver microsomes from all the three species. However, the inter-species differences were found in the view of relative amounts of the metabolites as well as the metabolic characteristics of estradiol in liver microsomal incubation.

Objective To investigate the honey and bran of processing for chemical compositions of Rosae Laevigatae Fructus.Methods With total polyphenols, total saponins, total polysaccharides and amino acids as the evaluation indexes, changes of the chemical compositions of these four chemical components in Raw product, honey products, bran products of Rosae Laevigatae Fructus were studied; in vitro activity of DPPH radical clearance for evaluation index, antioxidant activity of raw products, honey products, bran products of Rosae Laevigatae Fructus were compared.Results Raw products, honey products, and bran products of total saponin content were 3.332%, 4.880%, and 4.572%; total phenolic contents were 1.92%, 6.38%, and 7.30%; total polysaccharide contents were 35.99%, 40.38%, and 36.86%; the total amino acid contents were 0.67%, 0.76%, and 0.96%. Total polyphenol, total saponins, total polysaccharides, and total amino acids of Rosae Laevigatae Fructus after processing increased, in which the total polyphenol was most obvious; DPPH radical scavenging IC50 of raw products, honey products, and bran products were 0.47, 0.51, and 0.22 mg, respectively.Conclusion Compared with raw product, the content of chemical fractions in honey products and bran products of Rosae Laevigatae Fructus increase, and oxidation resistance is enhanced.

Objective To analyse the risk factors of medical complications after hip fracture surgery.Methods Clinical data of 327 hip fracture patients undergoing surgical treatment in Beijing Haidian Hospital from January 2009 to December 2013 were retrospectively studied.There were 114 males and 213 females with a mean age of (75.1 ±15.6) years, 129 patients(39.4%) had femoral neck fractures, and 198 patients ( 60.6%) had intertrochanteric fractures.Fifty four patients had medical complications during hospitalization ( complication group) and 273 patients did not have complications ( non-complications group ) . The clinical features, presurgical comorbidities and operative parameters were documented and compared between two groups.The risk factors of medical complications were assessed by regression analysis.Results Univariate analysis showed that age ( t =2.85, P=0.007), lying in bed before fracture(χ2 =12.86,P =0.000), the history of chronic obstructive pulmonary diseases(COPD) (χ2 =9.45, P=0.000), coronary heart disease(χ2 =10.67,P=0.000), heart failure(χ2 =15.85,P=0.000), diabetes (χ2 =3.22,P=0.024), cerebrovascular disease(χ2 =4.21,P=0.008), anesthesia method(χ2 =8.67,P=0.018), American Society of Anesthesiologists(ASA) score ≥3 level(χ2 =2.01, P=0.042) and the delay time of operation (t=4.24, P=0.037) were significantly different between two groups.Multivariate regression analysis revealed that age(β=0.030, OR=1.030), lying in bed before fracture (β=2.303, OR=10.716), the history of COPD (β=0.831, OR =1.995), coronary heart disease(β=0.858, OR=2.392), heart failure(β=1.971, OR=7.333)and ASA score ≥3 level(β=0.809,OR=2.583) were the independent risk factors of medical complications after hip fracture surgery. Conclusion Age, lying in bed before fracture, the history of COPD, coronary heart disease, heart failure and ASA score≥3 level would increase the risk of postoperative medical complications for patients with hip fracture.

Objective To evaluate the effect of continuous passive motion (CPM) as an adjunct to active physiotherapy on pain and range of motion (ROM) after knee arthroplasty. Methods 20 female osteoarthritis patients (40 knees) undergoing bilateral knee arthroplasty were assigned into two groups. The experimental group received CPM and active physiotherapy twice a day while the control group received active physiotherapy only. They were assessed with visual analogue scale (VAS) and goniometer on pain and ROM of knee before and after operation. Results There were no statistical difference between these two groups for any outcome measures either 2 weeks or 3 months after operation (P>0.05), and they all improved in pain and ROM 3 months after operation compared with before (P<0.01). Conclusion CPM as an adjunctive therapy is not found to have an additional effect on pain or ROM 3 months after operation while active physiotherapy was used.

OBJECTIVE: To investigate the relationship between the perfusion CT features and the clinicopathologically determined prognostic factors in advanced gastric cancer cases. MATERIALS AND METHODS: A perfusion CT was performed on 31 patients with gastric cancer one week before surgery using a 16-channel multi-detector CT (MDCT) instrument. The data were analyzed with commercially available software to calculate tumor blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS). The microvessel density (MVD), was evaluated by immunohistochemical staining of the surgical specimens with anti-CD34. All of the findings were analyzed prospectively and correlated with the clinicopathological findings, which included histological grading, presence of lymph node metastasis, serosal involvement, distant metastasis, tumor, node, metastasis (TNM) staging, and MVD. The statistical analyses used included the Student's t-test and the Spearman rank correlation were performed in SPSS 11.5. RESULTS: The mean perfusion values and MVD for tumors were as follows: BF (48.14+/-16.46 ml/100 g/min), BV (6.70+/-2.95 ml/100 g), MTT (11.75+/-4.02 s), PS (14.17+/-5.23 ml/100 g/min) and MVD (41.7+/-11.53). Moreover, a significant difference in the PS values was found between patients with or without lymphatic involvement (p = 0.038), as well as with different histological grades (p = 0.04) and TNM stagings (p = 0.026). However, BF, BV, MTT, and MVD of gastric cancer revealed no significant relationship with the clinicopathological findings described above (p > 0.05). CONCLUSION: The perfusion CT values of the permeable surface could serve as a useful prognostic indicator in patients with advanced gastric cancer.
Adult ; Aged ; Female ; Humans ; Lymphatic Metastasis ; Male ; Microcirculation ; Middle Aged ; Prognosis ; Prospective Studies ; Regional Blood Flow ; Stomach Neoplasms/*blood supply/pathology/*radiography ; *Tomography, X-Ray Computed

Objective To compare the clinical effect of Multiloc nailing and Philos locking plate for treating proximal humerus fracture.Methods A retrospective analysis of 34 surgery treated proximal humeral fractures patients in Department of Orthopedics,Beijing Haidian Hospital and Department of Orthopedics,Beijing Chaoyang Hospital,Capital Medical University from January 2015 to June 2016,in which 3 cases of high-energy injury and multiple fractures andonecase of humerus head replacement and onecase of non-surgical treatment were excluded.Finally,29 patients were included and clinical followed up to 12 months after surgery.The 29 paients were divided into the locking plate group (n =13) and intramedullary nail group (n =16),The operative time,volume of intraoperative blood loss,preoperative to postoperative 24 patients were compared between the locking plate group and intramedullary nail group underwent open reduction and internal fixation with philos locking plate hemoglobin changes,24 h postoperative visual analogue scale and 3,6,12 months postoperative Constant-Murley shoulder function score.SPSS13.0 statistical software was used to analyze the data.Measurement data were expressed as ((x) ± s).Comparison of groups used independent samples t test,repeated measurement data used repeated measures analysis of variance.Results The age of the locking plate group was (65.7 ± 9.3) years,and the age of the intramedullary nailing group was (65.6 ± 11.1) years.In the locking plate group,the operation time was (150 ± 17) minutes,the intraoperative blood volume was (300 ± 53) ml,the change of blood pigment between before surgery to 24 hours after surgery was (26 ± 8) mg/L,and the vision algetic standard of 24 hours after surgery was (3.4 ± 0.8) scores.In intramedullary nailing group,the operation time was (119 ± 13) minutes,the intraoperative blood volume was (130 ± 25) ml,and the change of blood pigment between before surgery to 24 hours after surgery was (11 ± 5) g/L,the vision algetic standard of 24 hours after surgery was (2.3 ± 0.5) scores.No serious postoperative complications occurred in either group,including infection,internal fixationfailure,and humeral head necrosis.In locking plate group,for the Constant-Murley shoulder joint function score,3 months after surgery was (76.0 ± 11.6) scores,6 months was (78.0 ± 13.4) scores,12 months was (88.0 ± 12.1) score.In intramedullary nailing group 3 months was (85.0 ± 9.7) scores,6 months was (87.0 ± 8.9) scores,12 months was (89.0 ± 10.3) scores.There were no statistical difference between the two groups at incidence of serious complications after surgery,postoperative 12 months Constant-Murley shoulder joint function score.Muhiloc intramedullary nailing group was better than Philos locking plate group in the operation time,the intraoperative blood volume,etc.Conclusion Multiloc intramedullary nail is an effective method for treating proximal humerus fracture,and it has the advantages of less surgical injury and early postoperativesatisfactory than the locking plate.