Objective To study the new anticoagulants, felling shaaban joint care used in joint replacement for prevention of deep vein thrombosis.MethodsThe Second People's Hospital of Chengdu orthopaedics in March 2016 to March 2017 were hospitalized patients with knee joint replacement and total hip replacement of the 158 patients, according to the stochastic indicator method were randomly divided into observation group and control group, 79 cases in each group, the observation group received new anticoagulants, cutting class joint care, the control group accepted low molecular weight heparin calcium in combination with care.Observe two groups of treatment of deep vein thrombosis prevention effect and adverse reactions.ResultsCompared with control group, the observation group with lower incidence of DVT and difference comparing the two groups have statistical significance (P<0.05).Observation group compared with control group, PT, APTT, preoperative and postoperative 2 day, five days did not have obvious difference, no statistical significance.Observation group compared with control group, subcutaneous ecchymosis, incision hematoma bleeding had no obvious difference).ConclusionThe laval shaaban joint care to prevent deep venous thrombosis after artificial joint replacement effect of low molecular weight heparin calcium is better, and coagulation function effect is small.

Glycogen synthase kinase-3βis a multifunctional Ser/Thr kinase , and its activity has been associated with many cell processes .The mitochondrial permeability transition pore is primed by ischemia to open upon reperfusion , leading to reperfusion induced cell necrosis .Phosphorylated GSK-3βpresumably inhibits mPTP opening by multiple mechanisms , including preservation of hexokinaseⅡin mPTP complex , prevention of interaction of cyclophilin-D with adenine nucleotide translocase , inhibition of P53 activation and attenuation of ATP hydrolysis during ischemia .

Objective To discuss the selection of different operation methods for cesarean scar pregnancy ( CSP ) . Methods A retrospective analysis was made on clinical data of 71 CSP patients treated in our hospital from January 2010 to January 2015.All the patients were accurately diagnosed by transvaginal color ultrasound examinations.Hysteroscopic evacuation was performed in 45 endogenous CSP patients, while in 26 exogenous CSP patients, 15 of them were treated by hysteroscopy and the other 11 patients were given laparoscopic operation. Results For the 45 endogenous patients, the success rate of hysteroscopic therapy was 92%( 41/45 ) .For the 26 exogenous patients, the success rate was 80% ( 12/15 ) for hysteroscopic and 82% ( 9/11 ) for laparoscopic therapy. Conclusions Preoperative categorizing of CSP is important for choosing different surgery methods. Hysteroscopic evacuation is the first choice for endogenous CSP.For exogenous patients, both hysteroscopic evacuation and laparotomy can be chosen.Therefore, the two minimally invasive procedures have limits, and transvaginal and laparotomy resection of lesion is still necessary sometimes.

Objective To explore clinical characteristics of spontaneous subarachnoid hemorrhage(SAM)pa- tients.Methods Etiopathogenisis and clinical manifestations of 167 SAIl patients of different ages and cause of 24 SAH patients' exacerbation and death were retrospectively analyzed.Results The aneurysm was the main etiologies of SAH.The youth and middle-ages SAH patients were caused by aneurysm.Hypertensive arteriosclerosis was the second etiologies of SAH which was mainly in middle-ages and old ages.SAH caused by Vascular malformation main- ly appeared in youth group.Headache and vomitus and meningeal irritation sign which mainly appeared in youth and middle-ages groups.Occiput pain and conscious disturbance was mainly the first symptoms of aggravation and death of SAH which happened in 14 days after hemorrhage and under 45 year ages.Conclusion Aneurysm and vascular malformations are the main causes of SAH of young patients.And hypertensive arteriosclerosis is the main cause of the old.The clinical manifestations of the old are not as typical as the young.Posterior cranial fossa hemorrhage is the main cause of SAH patients which are mostly under 45 year ages and mostly happen in 14 days after bleeding.

Objective:To analyze the clinical guidance value of 3.0 T three-dimensional time of fly magnetic resonance angiography (3D-TOF-MRA) in patients with trigeminal neuralgia (TN) who underwent microvascular decompression (MVD) treatment.Methods:The clinical and imaging data of 60 TN patients who underwent MVD treatment in Jinhua People′s Hospital from January 2019 to December 2019 were retrospectively analyzed. All patients underwent 3D-TOF-MRA examination before the surgery. The relationship and direction of the trigeminal neuralgia and surrounding blood vessels were observed, the responsible blood vessels that compressed the nerves before the surgery were determined, and vascular nerve compression (NVC) was clarified.Results:Among the 60 TN patients, pain symptoms of 52 patients (86.67%) completely disappeared after the surgery, and the pain symptoms of the remaining 8 patients (13.33%) were also significantly relieved. There was no statistically significant difference between 3D-TOF-MRA examination and MVD surgery in the judgment of the responsible vessel ( P>0.05). The positive rate of TN diagnosed by MVD surgery was 98.33% (59/60), and the positive rate of TN diagnosed by 3D-TOF-MRA was 91.67% (55/60), with no statistically significant difference ( P>0.05), and with highly consistency by Kappa test ( Kappa value=0.867). The area under the curve (AUC) of TN diagnosed by 3D-TOF-MRA through receiver operating characteristic (ROC) curve analysis was 0.730 (95% CI 0.526~0.934). The incidence of NVC diagnosed by 3D-TOF-MRA was 63.33%(38/60), and the incidence of NVC seen by MVD surgery was 61.67%(37/60). There was no statistically significant difference in the diagnosis of NVC between 3D-TOF-MRA and MVD surgery. ( P>0.05). Conclusions:The 3D-TOF-MRA examination can more accurately know the position, orientation, shape and compression degree of the responsible blood vessel in TN patients, which has important guiding value for the clinical diagnosis of TN and preoperative evaluation of MVD.

Objective To observe the ultrasonographic features of local chest wall tumor recurrence after mastectomy for breast cancer and its clinical and histopathological characteristics. Methods The ultrasonographic features, clinical and histopathological characteristics of 27 patients with local chest wall tumor recurrence after mastectomy confirmed histopathologically were retrospectively reviewed. Results The disease-free intervals of twenty-seven patients ranged from 3 to 129 months [mean (31.9±31.4) months]. Most of the recurrence(18/27, 66.7%) occurred within 3 years after mastectomy. The clinical manifestations were:7 cases (7/27, 25.9%) with regional skin redness and swelling, red rash or ulceration on chest wall associated with or without palpable mass, 20 cases(20/27, 74.1%) with chest wall palpable masses without obvious skin change. On ultrasonography, 2 cases showed diffuse inifltrative type with ill-deifned inhomogeneous hypoechoic lesion and skin thickening. And twenty-ifve cases(43 lesions) showed mass type with a lesion size range of 5.4-114.7 mm [mean (24.4±21.6) mm]. Among them, 32 lesions were located near to the operation incision scar, 36 involved muscle layer, 38 were hypoechoic, 31 had irregular shape, 24 had indistinct margin, and 31 had blood lfow signal. In addition, calciifcation, halo, and taller-than-wide shape were absent in all 43 lesions. Conclusions The tumor recurrence often occurred within 3 years after mastectomy in high-risk patients. Ultrasonographic feature of chest wall recurrent lesion is of great value in the diagnosis.

AIM: To compare the therapeutic effects of transplantation of human umbilical cord mesenchymal stem cells (hUCMSC) through different ways on diabetic mice.METHODS: hUCMSCs were labeled with enhanced green fluorescent protein (EGFP) and luciferase (Luc) reporter gene, and then the cells were transplanted into the diabetic mice through pancreas or tail vein to monitor the migration of the hUCMSCs in vivo.The pathological changes of pancreas tissue sections were determined by HE staining.Weight and blood glucose of the mice were measured dynamically.To compare the therapeutic effects, serum insulin levels were analyzed and glucose tolerance test were also performed.RESULTS: In vivo bioluminescence imaging results showed that the hUCMSCs transplanted into pancreatic capsule was mainly located in the pancreas while the hUCMSCs transplanted through vein tail injection was mainly located in the lung.HE staining illustrated that islet cells presented distinctive boundary and no infiltration of inflammatory cells in pancreatic capsule transplantation group was observed, but a little inflammatory cell infiltration and fibrosis formation in tail vein injection group were seen.A significant decrease in blood glucose level and a significant increase in serum insulin level in pancreas transplantation group were showed as compared with vein tail injection group.CONCLUSION: Transplantation of hUCMSCs through different approaches demonstrates different effects.The transplantation of hUCMSCs into pancreatic capsule is more effective on hyperglycemia reversion, insulin secretion and improvement of beta-cell function than that through tail vein.

ObjectiveTo evaluate the effect of increasing doses of tamsulosin in lower urinary tract symptom (LUTS) of benign prostatic hyperplasia (BPH).MethodsA prospective self-controlled clinical trail was performed.Two hundred and sixty-one patients who had LUTS of BPH were enrolled in this prospective 4 weeks study of tamsulosin.The patients were randomly divided into 2 groups:took tamsulosin 0.2 mg QN (n =126,group A) and 0.4 mg QN (n =135,group B) respectively.The IPSS score and maximum flow rate before and after treatment were compared between the 2 groups.ResultsThe IPSS score of group A decreased from 17.72 ± 2.50 to 10.21± 1.95,average decreased 7.59 ± 2.74 ； maximum flow rate was elevated from (8.78 ± 3.70) ml/s to ( 12.74 ± 2.99 ) ml/s,average increased (4.31 ± 3.01 )ml/s.The IPSS score of group B decreased from 19.24 ± 3.22 to 11.21 ± 3.02,average decreased 8.49 ±3.73； maximum flow rate was elevated from (7.74 ± 1.97) ml/s to ( 12.04 ± 2.46) ml/s,average increased (4.73 ± 2.97) ml/s.There was no significant difference of the changes of IPSS score between the 2 groups ( P ＞ 0.05 ),but there was a significant difference of the changes of maximum flow rate between the 2 groups ( P ＜ 0.05 ).The results was further analyzed by sub grouped ( by patient body weight,divided into ≤55.0 kg,55.1 -65.0 kg,65.1 -75.0 kg,＞75.0 kg group).There were significant differences of the changes of IPSS score and maximum flow rate between the 2 groups in 65.1 - 75.0 kg and ＞ 75.0 kg subgroups ( P ＜ 0.05 ).The incidence of side effects between the 2 groups was not significantly different (P ＞ 0.05).ConclusionsFor most patients,the use of high-dose tamsulosin in improving LUTS caused by BPH can not bring significant benefits.But if the patient's weight is more than 65.0 kg,increasing the dose of tamsulosin is suggested for consideration.

OBJECTIVE:To optimize the inclusion process of the volatile oil of Pogostemon cablin and Acorus tatarinowii in Xiaoyu anshen capsule.METHODS:The inclusion process was carried out by saturated water solution method.And the inclusion process was optimized by orthogonal experiment with the inclusion ratio and yield of the volatile oil as indexes taking the ratio of volatile oil to ?-CD,the temperature and the time of inclusion as factors.The physical phase of the inclusion complex was detected by differential scanning calorimetry(DSC).RESULTS:The optimum inclusion process was established as follows:the ratio of oil to ?-CD=1∶8;the ratio of water to ?-CD=10∶1;the inclusion time was 1h and the inclusion temperature was 50 ℃.The inclusion rate was as high as 90%.The DSC revealed that a new physical phase has been formed for the inclusion complex.CONCLUSION:The intermolecular inclusion complex with good stability and high yield of volatile oil could be obtained from the optimized inclusion process.

Purpose To evaluate the value of multi-slice spiral computed tomography (MSCT) scan in the diagnosis of papillary renal cell carcinoma. Materials and Methods A retrospective study was conducted on the findings of plain CT scan and triphasic dynamic contrast enhanced CT scan of 23 patients with papillary renal cell confirmed pathologically, and further contrasted with the findings of 96 patients with clear cell renal cell carcinoma at corresponding phases in such aspects as cystic degeneration, enhancement degree and pattern (homogeneous, peripheral or heterogeneous) and tumor spreading pattern (perinephric invasion, lymphadenopathy or venous invasion). Results The degree of enhancement CT value for both diseases showed statistical significance in corticomedullary phase, parenchymal phase and excretory phase (t=9.70, 8.08, 5.92;P<0.01), but papillary renal cell carcinoma was lower than clear cell renal cell carcinoma. In terms of cystic degeneration, papillary renal cell carcinoma was significantly lower than clear cell renal cell carcinoma (21.7%vs 54.2%,χ2=7.54, P<0.01). Papillary renal cell carcinoma mainly showed homogeneous enhancement (60.9%) whereas clear cell renal cell carcinoma mainly presented heterogeneous enhancement (68.8%) with statistical difference (χ2=30.40, P<0.01). The tumor spreading patterns like perinephric invasion, lymphadenopathy and venous invasion had no significant difference (χ2=0.51, 0.11, 0.03;P>0.05). Conclusion Papillary renal cell carcinoma shows homogeneous enhancement, seldom cystic degeneration or necrosis on MSCT scan, which is helpful for the differential diagnosis from clear cell renal cell carcinoma.