BACKGROUND:Many patients underwent aspirin anticoagulation in preventing cardiovascular disease before hip and knee replacement. No report addressed the effect of aspirin on blood loss during perioperative stage in patients receiving hip and knee replacement. OBJECTIVE:To observe the effect of perioperative continuous low-dose aspirin anticoagulation application on total hip arthroplasty or total knee arthroplasty. METHODS: A total of 40 patients with primary total hip arthroplasty or total knee arthroplasty were enroled in the Department of Orthopedics, Tianjin First Center Hospital from December 2012 to August 2013. According to anticoagulation scheme, they were divided into two groups (n=20). In the observation group, 100 mg/d aspirin anticoagulation was continuously used before replacement for a long period, and the medicine was not withdrawn except the day of replacement. In the control group, aspirin anticoagulation was not used, and their ages were similar to the observation group. The operation was conducted by the same physician in the observation and control groups. 10 patients received total hip arthroplasty and 10 patients received total knee arthroplasty in both groups. Bleeding was stopped actively during replacement. After replacement, pressurized ice compress was used to reduce bleeding. At 48 hours after replacement, wound drainage, perioperative hemoglobin and the incidence of complications were recorded. Joint function recovery was observed at 3 months of folow-up. RESULTS AND CONCLUSION:Hemoglobin levels before and after operation, postoperative blood drainage at 48 hours, perioperative hemoglobin changes, the incidence of complication, and joint function score at 3-month folow-up did not show significant difference between both groups. These findings indicate that it is safe to use some measures for reducing blood loss and continue low-dose aspirin in the perioperative period. The use of aspirin did not impact blood loss.

OBJECTIVE:To explore the clinical efficacy and safety of nedaplatin combined with docetaxel in the treatment of advanced cervical cancer. METHODS:A total of 53 patients with advanced cervical cancer selected from our hospital during Apr. 2014-Apr. 2016 were divided into observation group(31 cases)and control group(22 cases)according to chemotherapy plan. Con-trol group was given Docetaxel injection 60 mg/m2,ivgtt,qw. Observation group was additionally given Nedaplatin for injection 35 mg/m2+0.9% Sodium chloride injection diluted into 500 mL,ivgtt (≥60 min),qw. A chemotherapy cycle lased for 21 d,and both groups received 2 cycles of chemotherapy. Clinical efficacies of 2 groups were evaluated 2 weeks after treatment,and the level of PCNA integal was detected before and 2 weeks after treatment. The occurrence of ADR was recorded. RESULTS:The total re-sponse rate of observation group (77.42%) was significantly higher than that of control group (63.64%),with statistical signifi-cance(P<0.05). Before treatment,there was no statistical significance in PCNA integval between 2 groups(P>0.05). After treat-ment,PCNA integval of 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance(P<0.05). ADR were concentrated in grade I,and there was no statistical significance in the in-cidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Docetaxel combined with nedaplatin can significantly improve the clinical efficacy of patients with advanced cervical cancer,and does not increase the adverse reactions compared to docetaxel alone.

Objective To assess the current status of knowledge, attitude and practice (KAP) towards antibiotic use among community residents in Hangzhou, and to explore the correlations among them. Methods A total of 449 permanent residents in Hangzhou were randomly selected using a multistage stratified random sampling method. Self-reported data on basic demographic factors, and relevant KAP information were collected by the questionnaire survey. Differences in KAP scores according to each demographic factor were assessed by the t test or ANOVA test, and AMOS 21.0 was used for the path analysis. Results Scores for knowledge, attitude and practice regarding antibiotic use were (6.17±2.45), (6.45±0.99) and (6.21±1.02) respectively. Results of the path analysis showed that education level and age had effects on the knowledge (coefficients: 0.57 and -0.38 respectively) . Age, gender and knowledge had effects on the attitude (coefficients: -0.27, 0.12 和 0.02 respectively), and attitudes, gender, monthly income and the level of education had effects on the practice (coefficients: 0.48、 0.37、 0.06 and 0.02 respectively) . Conclusion Community residents in Hangzhou lack relevant knowledge, and there are some irrational attitudes and practices regarding antibiotic use. There is a correlation between knowledge and attitudes, as well as between attitudes and practices, but the knowledge and practices are not correlated.

Objective To evaluate the method of establishment of a minipig model of ischemic heart failure(HF) with acute myocardial infarction(AMI) by coronary balloon occlusion and coadministration of injecting of microthrombi and plastic microspheres.Methods A total of eighteen minipigs were selected.After coronary angiography,angioplasty balloons were placed in the mid-distal of left anterior descending(LAD).The balloon was inflated intermittently to occlude the LAD 3 times and then to occlude it continuously for 120 minutes.After the balloon was taken out,4F Judkins-type angiogrphic catheter was superelectively engaged in LAD and 3 mL intermixture of mierothrombi and plastic microspheres were injected at 10 minites interval until TIMI myocardial perfusion was grade<2 and left ventfieular end-diastolic pressure was maintained from 15 to 18 mmHg.Electrocardiogram(ECG),hemodynamic perameters,ultrasonic cardiogram,cTnI and CK-MB were measured.Myocardial infarction area was evaluated by histopathology.Results Fourteen days later,fifteen minipigs survived and fourteen satisfied the criteria(pulmonary capillary wedge pressure.PCWP>18 mmHg and eardio output (CO) decreased beyond 30% ). The changes of ECG, hemodynamic perameters, CKMB, cTnI and cardiac pathologic examination were in accordance with AMI. Conclusion A stable experimental method of establishment of minipig model of ischemic heart failure (HF) with acute myocardial infarction (AMI) by coronary balloon occlusion and coadministration of injecting of microthrombi and plastic mierospheres is succeded. This method has advantages such as closed chest, higher success rate and stability compared with the drug induced, taehycardia-pacing induced, coronary artery ligation induced or microsphere injection alone methods.

Objective:To investigate the differences in efficacy, survival outcomes, and acute and late toxicities for patients with local/regional advanced nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy (IMRT) in combination with che-motherapy (CT) and by IMRT alone. Methods:A total of 72 newly diagnosed local/regional advanced NPC patients were randomly subjected to IMRT/RT+adjuvant CT (after radiotherapy, RT) (n=42) or IMRT+adjuvant CT (after RT) (n=30). The Kaplan-Meier meth-od was used to analyze the two-year local/regional control rates, distant metastasis-free survivals, and overall survivals. The acute and late radiation toxicities were evaluated based on the toxicity criteria of the Radiation Therapy Oncology Group and European Organiza-tion for Research and Treatment of Cancer. Results:A median follow up period of 13.5 months was included in the study. The one-year and two-year local/regional control rates, distant metastasis-free survivals, and overall survival in the IMRT group were 95.0%, 80.0%, and 95.0%, and 80%, 60.0%, and 75.0%, respectively. For the IMRT+CT group, such rates were 100%, 96.4%, and 96.4%, and 100%, 92.9%, and 92.9%, respectively. The two-year local/regional control rate and distant metastasis-free survivals in the IMRT+CT group were higher than those in the IMRT group (P<0.05). Most patients had grade 1 to grade 2 acute radiation toxicities and grade 0 to grade 1 late radiation toxicities (P>0.05). No patient showed a grade 4 acute or late toxicity. The blood and gastrointestinal toxicity rates were high in the IMRT+CT group (P<0.05). Conclusion:The IMRT+CT treatment has potential advantages over the IMRT in the treatment of local/regional advanced NPC patients in terms of local/regional control and overall survival. The blood and gastrointestinal toxicity rates in the IMRT+CT group were higher than in the IMRT group but still within a tolerable range.

OBJECTIVE: To study surgical techniques and clinical applications of the intranasal endoscopic combined middle meatus and expand prelacrimal recess-maxillary ainus approach for orbital fracture treatment. METHOD: A retrospective clinical analysis of 3 patients whose admitted for orbital floor fractures or medial wall fractures operated by the intranasal endoscopic middle meatus with expand prelacrimal recess-maxillary ainus approach surgical treatment was studied, and the treatment effects and the postoperative complications were analyzed. RESULT: All patients had been followed up for 6 to 12 months. All cases of diplopia symptom were disappeared, enophthalmos were totally corrected, no cases of complication were found. CONCLUSION Endonasal endoscopic combined middle meatus and expand prelacrimal recess-maxillary ainus approach for orbital fracture treatment have great and clear view. This approach with less tissue damage and high therapeutic effect makes the cost lower than other methods and complications will be decreased as well, it has a great advantage in the orbital fracture treatment.
Diplopia ; etiology ; therapy ; Endoscopy ; Enophthalmos ; etiology ; therapy ; Humans ; Maxillary Sinus ; surgery ; Nose ; Ophthalmologic Surgical Procedures ; methods ; Orbital Fractures ; complications ; surgery ; Postoperative Complications ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies

Objective To evaluate the short term effect of bipolar arthroplasties in aged cases with intertrochanteric fractures.Methods There were 23 males and 15 females(at age of 70-93 years, average 76 years)with unstable intertrochanteric fractures treated with the third generation cementing techniques and bipolar arthroplasties that were followed up for average 2.4 years.The clinical effect was evaluate with Harris scale,X-ray films and complications.Results Of all,34 cases(89.5%)could walk freely.The average Harris scale was 84.2 points.The average period until walk with full-weight load was 5.6 weeks.The greater trochanters was united in 35 cases(92%)during average 4.2 months.No peri-prothetic ossteolysis and loosening or subsidence occurred.Conclusions Cemented bipolar arthro- plasty has good advantages of reduced laying up period and few complications.The short-term outcome is satisfactory hut the long-term outcome needs deeper observation.

Objective To explore effects of endoscopic subtotal thyroidectomy on nodular goiter and its clinical significance.Methods From Jun.2004 to Dec.2009,72 patients with nodular goiter underwent endoscopic subtotal thyroidectomy in Southwest Hospital.Of the 72 cases,22 cases had left-side nodule,31 cases had right-side nodule and 19 cases had bilateral nodules.Single thyroid nodule occurred in 41 cases and multiple nodules in 31 cases.The total number of nodules was 113.The average nodule size was 2.8 cm(ranging from 0.4 to 6.3 cm).Results Of the 72 cases,19 patients underwent bilateral subtotal thyroidectomy and the mean operative time was 97 min(ranging from 80 to 150 min).53 patients underwent unilateral subtotal thyroidectomy and the mean operative time was 65 min(ranging from 25 to 120 min).The mean intraoperative blood loss was 45 ml (ranging from 5 to 120 ml).Of the 72 cases,68 cases were given cervical plexus block regional anesthesia and among them 66 cases(97%)acquired good anesthesia.Temporary hoarse voice occurred in 2 cases and postoperative bleeding occurred in the subcutaneous tunnel of breast in 2 cases.Patients were followed up from 3 to 5years and the cosmetic result was satisfactory.The postoperative review half year later showed that unilateral nodule recurred in 1 case and the recurrence rate was 1.4%.Conclusions Endoscopic subtotal thyroidectomy through anterior chest wall or breast approach under local anesthesia is a safe and effective treatment in nodular goiter.In the process of dissecting thyroid,blunt maneuver and proper use of ultrasonic knife instead of clamping thyroid nodules directly are recommended in order to reduce intraoperative blood loss and enhance safe practice.

In order to cultivate clinical pharmacy undergraduates to have better quality, Chongqing Medical University collaborated with The University of Chicago and University of Cincinnati in the reform of the course of pharmacotherapeutics. We build pharmacotherapeutics series curriculum with the center of disease, construct department of clinical pharmacy for transnational departments, build course leader and teaching team of pharmacotherapeutics series curriculum , compile teaching program and its material of pharmacotherapeutics series curriculum, build pharmacotherapeutics series curriculum and teaching model in line with the current direction of China's education system of clinical pharmacy training, reform teaching methods, and strengthen clinical pharmacy practice and community clinical pharmacy education.

Objective To understand the prevalence and disease distribution of migrants within the water source area of the Middle Route Project of South-to-North Water Diversion Project and analyze the influencing factors. Methods By multi-stage stratified cluster sampling method, 307 immigrants and 676 immigrants were selected from Danjiangkou reservoir area, Shiyan city, Hubei Province. Results The prevalence of chronic diseases among in-migration was 51.8%. The prevalence rates of the top five chronic diseases were waist and leg pain, hypertension, gastritis, heart disease and diabetes. The prevalence of chronic diseases among out-migration was 65.1%. The prevalence rates of the top five chronic diseases were waist and leg pain, hypertension, gastritis, heart disease and bronchitis. The rate of chronic disease, the rate of two weeks and the rate of two weeks' visit were higher than that of emigration(all P<0.05). The results of multivariate analysis showed that the factors influencing the chronic diseases of immigrants were 60 years old (OR=59.928，P<0.001), unsatisfied family income (OR=0.377, P=0.002) and poor economic status (OR=0.517, P=0.028). The factors influencing the chronic diseases of immigrants were 60 years old (OR=26.190, P<0.001), smoking (OR=1.856,P=0.004), unsatisfactory family income (OR=0.598,P=0.029) and poor economic status (OR=0.460,P<0.001). Conclusions The prevalence of migrants within a high level is at a high level. Actually raising the income of immigrants is conducive to improving the health condition of immigrants.