[Objective]To study the effect of semi-constrained total elbow arthroplasty in rheumatoid elbow arthritis.[Method]Eighteen semi-constrained total elbow replacements were performed on 22 rheumatoid patients with 28 elbows(Morrey Stage:6 of Ⅲ Stage,17 of Ⅳ Stage,5 of Ⅴ Stage).The elbows were reviewed retrospectively after a followup of mean 26 months(range12~44 months).Mayo Elbow Performance was used to evalue the function of preoperative and postoperative elbow.The curative effect and complications were observed.The statistically significant differences were analyzed.[Result]Elbow arthroplasty was successful in 22 rheumatoid patients with 28 elbows.After 6 weeks function exercise the Mayo Elbow Performance was improved from(31.6?29.2)to(82.1?24.3)with a statistically significant difference(P

Objective To study the method and clinical results of Infrared Fluoroscopic Navigation Guiding system guided percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures.Methods Twenty-two cases with 32 osteoporotic vertebral compression fractures underwent percutaneous vertebroplasty guided by Infrared Fluoroscopic Navigation Guiding system.The fracture segment was within T6-L 4(14 thoracical vertebrae,18 lumbarver vertebrae).The compression ratio was from 20% to 90% in which 5 vertebral bodies were 75%.12 vertebral bodies underwent PVP,and 20 vertebral bodies underwent PKP in which balloon expansion were used in 12 vertebral bodies and sky expansion were used in 8 vertebral bodies.Single vertebral body injection were in 14 cases,two vertebral body injection were in 6 cases,three vertebral body injection were in 2 cases including 18 vertebral bodies injection via unilateral pedicle of vertebral arch and 14 vertebral bodies injection via bilateral pedicle of vertebral arch.Restoration of vertebra height and cement leakage was observed by postoperative X-ray and CT scan.Changes of preoperative and postoperative vertebral body volume measured by CT volumetry was compared.Preoperative and postoperative Vasual analogue scale(VAS)score was compared.Results PVP was successful in 22 cases with 32 vertebral bodies.No nerve and spinal cord damage,lung embolism and heart and brain vessel acute reaction occurred.Operative time was(18.4?4.5)mins per vertebral body.X-ray dosage was(12.2?3.4)dGy per vertebrae.The amount of bone cement was(4.4?2.5)ml per vertebrae.The vertebral body volume was improved from preoperative(22.2?8.6)cm3 to postoperative(24.8?6.9)cm3 with a significant differences(P

Objective To study curative effects of infrared fluoroscopic navigation guided percutaneous vertebroplasty for osteoporotic vertebral compression fractures. Methods A total of 28 cases of osteoporotic vetebral compression fractures(41 vertebrae) underwent infrared fluoroscopic navigation guided percutaneous vertebroplasty.The fracture was located at T_6～L_4 segment,including 16 thoracic vertebrae and 25 lumbar vertebrae.Fluoroscopic images of the spine were obtained,calibrated,and saved after the reference shelf was fixed on the spinous process of fractured vertebrae.The trajectory,a virtual tool corresponding to the tracked tool,was overlaid onto the saved fluoroscopic views in real time.Postoperative X-ray and CT examinations were performed to observe the vertebral body diaplasis as well as the distribution and leakage of bone cement.The vertebral body volume was measured with CT volumetry preoperatively and postoperatively.The visual analogue scale(VAS) scores were compared before and after operation. Results The bone cement was successfully injected in all the 41 vertebrae.Percutaneous vertebroplasty was performed in 13 vertebrae,while percutaneous kyphoplasty was conducted in 28 vertebrae(including balloon expansion in 12 vertebrae and "sky" expansion in 16 vertebrae).Vertebral body injection was performed via unilateral pedicle in 26 vertebrae and via bilateral pedicle in 15 vertebrae.Of the 28 cases,cement injection was carried out in one vertebral body in 17 cases,in two vertebral bodies in 9 cases,and in three bodies in 2 cases.No intraoperative deaths,nerve root or spinal cord injuries,or pulmonary embolism and cardiovascular or cerebrovascular emergencies occurred.The operative time for each vertebra was 7.7～20.7 min(14.2?3.3 min) in percutaneous vertebroplasty and 11.2～32.4 min(21.8?5.4 min) in percutaneous kyphoplasty.The X-ray exposure dose for each vertebra was 5.4～19.6 dGy(12.5?3.6 dGy).The amount of injected cement for each vertebra was 2.2 ～6.8 ml(4.6?1.2 ml).The vertebral volume was elevated from preoperative 21.4?4.6 cm3 to postoperative 25.8?5.4 cm3(t=5.623,P=0.000).The VAS scores decreased from preoperative 7.6?1.2 to postoperative 2.9?0.7(t=12.946,P=0.000).No serious complications or vertebral collapses were found during follow-up examinations for 3~14 months(mean,8 months) in the 28 cases. Conclusions Use of infrared fluoroscopic navigation for guiding percutaneous vertebroplasty is feasible.

BACKGROUND:Deep vein thrombosis after hip replacement has a high incidence rate. Moreover, deep vein thrombosis can induce pulmonary embolism that can endanger patients’ life and dysfunction of distant deep vein. The appearance of deep vein thrombosis is a great obstacle for the gradual y increased hip replacement.
OBJECTIVE:To observe the occurrence of deep vein thrombosis of lower limb after total hip replacement in elderly patients, and to screen the risk factors for the occurrence of deep vein thrombosis of lower limbs.
METHODS:Clinical data of 128 elderly patients with hip replacement were analyzed retrospectively. Al patients were examined with color Doppler ultrasound in double lower limbs at 1 day before replacement and 7 days after replacement. Multifactor unconditional logistic analysis was conducted on clinical related factors and the formation of lower limb deep vein thrombosis.
RESULTS AND CONCLUSION:At 7 days after the operation, 16 patients affected deep vein thrombosis of lower limb. The factors for deep vein thrombosis contained female, general anesthesia, bilateral hip replacement and the application of bone cement (P<0.05). The risk for deep vein thrombosis after total hip replacement significantly increased in elderly patients aged over 70 years. Multifactor unconditional logistic analysis exhibited that the multiple risks of sex, obesity and the use of bone cement in elderly patients with deep vein thrombosis increased to 11.398, 3.109 and 8.925. The patients with a blood type O at the age of over 70 years experienced a decreased risk for deep vein thrombosis after total hip replacement. The occurrence of deep vein thrombosis decreased to 0.186 times after replacement. Blood type O could be considered as a protective factor for the occurrence of deep vein thrombosis.

Gastric cancer has become a major public health problem in China because of its high prevalence. CircRNA could stably exist in various human body fluids, providing the innate advantage for the liquid biopsy, which makes it a research hotspot in the field of precision therapy in recent years. Based on the biological characteristics of circRNAs, we summarize the research progress of circRNAs in the early diagnosis, treatment monitoring and prognosis assessment of gastric cancer through literature retrieval in mainstream databases such as PubMed, Web of Science and CNKI. We also discuss the possibility and reliability of circRNA as an emerging liquid biopsy biomarker, to offer a vision for the development and clinical transformation of circRNA as a molecular marker of the diagnosis, treatment, evaluation and prognosis of gastric cancer in the future.

Objective To evaluate the application of infrared fluoroscopic navigation guiding pedicle screwfixation of thoracic-lumbarspine.Methods The pedicle screw fixation of thoraic-lumbar spine was adopted in 32 patients,including 19 cases with thoracic-lumbarspine fractures,5 cases with protrusion of lumbar intervertebral disc or vertebral canal stenosis,8 cases with lumbar spine slippage.The timefor pedicle screwfixation and amount of bleeding were recorded.The pedicle screwposition was assessed with post-operative CTby using An-drewgrade.Results Totally148 screws were fixed in 32 cases successfully,including10 screws in T11,20 in T12,18 in L1,36 in L2,16 inL3,26 in L4,28 in L5,and 14 in S1.According to andrewgrade,165 screws were inⅠgrade(98%),2 inⅡgrade,and 1 inⅢ grade.Nonerve and spinal cord damage was observed after operation.The average time of per pedicle screwfixation was(10?2.4) min.The averageamount of bleeding was(400?52.3) ml in thoracic-Lumbar Spine fractures,(200?36.8) ml in protrusion of lumbar intervertebral disc orvertebral canal stenosis,and(300?44.6) ml in Lumbar Spine slippage.Conclusion Infrared fluoroscopic navigation can improve the pre-cision of pedicle screw fixation of thoraic-lumbar spine,reduce the amount of bleeding,and shorten the operative time.

Clinical data of 380 patients with type 2 diabetes mellitus (T2DM) admitted in the Second Hospital of Tianjin Medical University from October 2014 to June 2017 were retrospectively reviewed. Patients were divided into 3 groups according to the results of lower extremity arterial ultrasonography: 103 patients without lower extremity arterial disease (group A), 132 patients with mild arterial disease (group B), 145 patients with moderate to severe lower extremity arterial disease (group C);and 100 healthy subjects served as control group. Blood routine parameters and blood biochemistry were measured;the results showed that blood cell ratios in T2DM patients were significantly higher than those in control group (P<0.05), and blood cell ratios in group B and group C were higher than those in group A (P<0.05). Pearson correlation analyses indicated that neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), hs-CRP, HbA1c, LDL-C were significantly associated with lower extremity arterial disease in T2DM patients. Logistic analysis showed that NLR(OR=2.01,95％CI:1.15-3.63,P<0.05)and PLR(OR=1.75,95％CI:1.04-3.28,P<0.05)were risk factors for lower extremity arterial disease in patients with type 2 diabetes mellitus.

Objective Optimizing the extraction process of prescription medicinal materials of hospital preparation of compound Yangshe granules. Methods A high performance liquid chromatograph (HPLC) quantitative method was established for deacetyl asperulosidicacid methyl ester (DME) and ferulic acid (FC) of the active ingredient. Based on the content of DME, FC and the yield of extract, the extraction process of compound Yangshe granule extract was optimized using central composite design-response surface methodology. Results The established HPLC method of quantification of active components in compound Yangshe granules met the requirements of method validation. The optimal extraction process optimized by central composite design-response surface methodology were as follows: the weight of extraction solvent was 12 times of the medicinal slices, the alcohol concentration was 73% and the extraction time was 60 min. Conclusion In this study, the quantitative method of active components in compound Yangshe granule by HPLC has been successfully established, and the optimized extraction process is simple and easy to operate with good repeatability.