Adult ; Bone Neoplasms ; pathology ; surgery ; Femur Neck ; pathology ; Humans ; Male ; Osteochondroma ; pathology ; surgery

Objective To compare postoperative pulmonary infection in patients undergoing surgical operation at different surgical opportunities.Methods Patients who underwent surgical operation in a hospital from January to December 2014 were surveyed retrospectively,patients' data were reviewed,patients with postoperative pulmonary infection were compared.Results A total of 20 343 surgical patients were investigated,227(1.12％) had postoperative pulmonary infection.Postoperative pulmonary infection rate in patients undergoing emergency operation was higher than that of selective operation (5.13 ％ vs 0.70 ％,x2 =307.49,P＜0.001).Postoperative pulmonary infection rates in patients undergoing emergency neurosurgical,general surgical,and cardiothoracic surgical operation were all higher than selective operation (all P ＜ 0.001).Among patients with pulmonary infection following emergency operation,the proportion of those who aged ＜60 years,with preoperative irrational antimicrobial use,cardiovascular disease,hypertension,and tracheotomy were all higher than those who received selective operation (all P＜0.05);the proportion of patients with cancer is lower than that of elective surgery patients(P＜0.05).Conclusion Postoperative pulmonary infection rate in patients undergoing emergency operation is higher than selective operation,postoperative pulmonary infection rates in patients undergoing emergency neurosurgical,general surgical,and cardiothoracic surgical operation are high.Patients with cardiovascular disease and hypertension are the focus of protection;for elective surgery,cancer patients are the focus of protection.

Objective To study the influence of ammoniummeta vanadate on the histological structure of jejunum of rats. Methods One hundred and twelve healthy and clean SD rats were randomly divided into the high dosage (60 mg/L),the moderate dosage(40 mg/L),the low dosage(20 mg/L) and the control group(distilled water),28 in each group,the males and females in the same number,the administration was conducted through drinking water,for 8 consecutive weeks. In the 4th and 8th weeks,the length of jejunum villus,the depth of jejunum gland and the thickness of jejunum wall were measured,the ratio of villus length and gland depth were counted and the pathological examination was done. Results With the increase of ammoniummeta vanadate,the weight of SD rats,the jejunum villus length,the depth of the jejunum gland,the wall thickness had showed a downward trend,the ratio of villus length and gland depth were significantly lower (P

Complement system is a reaction system comprising 35 proteins with enzyme activity common in serum,tissue fluid and cell membrane. It plays an important role in anti-infection. Abnormal complement activation is involved in incidence and progression of many inflammatory diseases. The complement is activated through typical,alternative and agglutinin pathways. Following cardiovascular stent implantation,the vessel endothelium of patients with coronary atherosclerotic heart disease is damaged; serum complement C3 could enter the arterial wall to damage arterial cells to enhance the permeability release antigenic components of vessel wall,and induce antibody production. The fixing immune complex is formed and induces platelet aggregation,attachment or lipidoses. Although humoral immunity becomes accentuated following cardiovascular stent implantation,the capability to resist microorganism is reduced,which stimulates self-protection of C3,aggravates inflammation,increases circulation complex,activates complement system and aggravates endothelial injury. C3 plays an essential role in occurrence and development of ischemic cardiovascular disease,and is an important cause for restenosis and thrombosis following cardiovascular stent implantation.

Objective To study the incidence rate and correlation of anomalous pancreaticobiliary ductal junction( APBDJ) for patients with biliogenic chronic pancreatitis (BCP). Methods From January 2000 to January 2012,the data of 1 373 patients who underwent ER-CP,MRCP or T-Tube cholangiography in which both biliary and pancreatic ducts in our hospital were analyzed retrospectively. Results Bil-iogenic chronic pancreatitis was found in 47 patients,of which 17 patients with APBDJ. The mean (SD) common channel was (19. 3±7. 2) mm in length ( range 11~40 mm) . Conclusion APBDJ may be the important reason of BCP among Chinese patients.

Objective To analyze the effect of different postoperative nutrition:enteral nutrition( EN) and parenteral nutrition( PN) in patients with colorectal cancer. Methods 84 patients with colorectal cancer were collected in this study from Jan. 2012 to Jan. 2014, and they were divided into the EN group (43 cases) and the PN group (41 cases). They were given EN or PN after operation. The nutritional parameters such as ALB, TF and PA were detected before surgery and 7 days after operation, Observe the adverse reaction, time of gastroin-testinal function recovery, infection and costs after operation. Results There was no statistical difference (P>0. 05) in the nutritional pa-rameters and rate of adverse reaction between the two groups. The rate of infection in EN group was lower than that in PN group(P<0. 01), and the time of gastrointestinal function recovery was shorter in EN group compared with that in PN group (P<0. 01). Conclusion EN is better in recovery of gastrointestinal function, and there is less complication compared to PN. EN have clinical application value for patients with gastrointestinal cancer.

Objective To study the clinic imaging features and the clinic applications of the contrastenhanced ultrasound(CEUS) in the diagnosis of gallbladder carcinoma.Methods The characteristics of CEUS were reviewed in 24 patients with gallbladder carcinoma proven pathologically. Results After injection of SonoVue, all gallbladder carcinoma of 24 cases showed enhancement and these lesions looked clearer than those in conventional ultrasound.The analysis of time-intensity curve indicated the upslope of curve was steep in the lesions,which was flat in normal liver parenchyma around.In 10 cases of thick wall of gallbladder carcinoma, quick and obvious enhancement was seen in 9 cases, 1 case showed poor enhancement during scanning,but thick and tortile blood vessels could be seen in the thickening wall.Quick and uneven enhancement was been seen in both 8 cases of soft-tissue mass and 6 cases of nodules within gallbladder.Five cases of gallbladder carcinoma with liver metastasis revealed more liver metastasis depend on CEUS.Conclusions CEUS plays an important role in diagnosis and improving the diagnostic accuracy for gallbladder carcinoma.

Objective To evaluate the value of flow cytometry ( FCM) for the differential diagnosis between myelodysplasia (MDS) subtype refractory cytopenia with multiple dysplasia (RCMD) and aplastic anemia (AA). Methods The flow cytometric data of bone marrow samples from 168 cases of RCMD and 77 cases of AA were analyzed retrospectively in blind, and its results were compared with gold standard to evaluate its diagnosis values. Results The specificity of abnormal of single immunophenotype in the surface of granulocytes and myeloblasts was high (range 75.3% -100% ) , but the sensitivity was very low (range 5.4%-50% ). In parallel tests, the sensitivity and specificity of the combination of CD+34 cells≥1% , myeloblasts ≥3% , abnormal expression of CD117 in granulocytes and loss of CD13 in myeloblasts or increased intensity of CD33 in granulocytes were higher than other combinations. The sensitivity and specificity of above combination were more than 62% and 92% , respectively. In the scoring method,different score was given to 8 markers according to different diagnostic value, which were CD+34 cells ≥1 % ,myeloblasts≥3% , abnormal expression of CD117 in granulocytes, loss of CD13 in myeloblasts, increased intensity of CD33 in granulocytes, loss of CD13 in granulocytes, loss of CD10 in granulocytes, and decreased SSC in granulocytes. The sensitivity and specificity were both high if we defined that the total score ≥1.5 was RCMD and the score < 1. 5 was AA. Conclusions The value of abnormal of single immunophenotype for differential diagnosis between RCMD and AA is low. Parallel tests can increase the diagnostic sensitivity obviously and not decrease the specificity. CD+34 cells≥1% , myeloblasts≥3% and abnormal expression of CO117 in granulocytes were the most important markers. The scoring method is precise to distinguish RCMD from AA.

OBJECTIVETo investigate the risk of hidden blood loss about applying rivaroxaban after total hip arthroplasty.

METHODSFrom October 2009 to May 2012,88 patients with femoral head necrosis were treated with primary total hip arthroplasty. All the patients were divided into Rivaroxaban group(44 cases)and control group(44 cases). There were 25 males and 19 females in the Rivaroxaban group, with an average age of (58.48 +/- 15.19) years old; in the control group,24 patients were male and 20 patients were female, with an average age of (61.11 +/- 13.54) years old. The patients in the Rivaroxaban group took Rivaroxaban orally from the first day after operation with a dose of 10 mg each day, and treatment course was 14 days. The patients in the control group took placebo orally at the same time. Dominant blood loss and transfusion were recorded, blood routine examinations were taken before operation and at 3 days after operation. The total blood loss and hidden blood loss were calculated according to the formula.

RESULTSThe mean total blood loss was (1509.56 +/- 325.23) ml and the hidden blood loss was(581.47 +/- 215.01) ml, accounting for (37.88 +/- 10.42)% in the Rivaroxaban group. The mean total blood loss was (1262.30 +/- 397.95) ml and the hidden blood loss was (395.59 +/- 97.33) ml, accounting for (30.62 +/- 0.20)% in the control group. The total blood loss, hidden blood loss and transfusion in the Rivaroxaban group was significantly more than those in control group,b ut there was no significant difference on dominant blood loss between two groups.

CONCLUSIONRivaroxaban increased the overall bleeding risk of total hip arthroplasty, especially hidden bleeding risk, which should be careful used.

Arthroplasty, Replacement, Hip ; adverse effects ; Case-Control Studies ; Female ; Hemorrhage ; etiology ; prevention & control ; Humans ; Male ; Middle Aged ; Morpholines ; pharmacology ; Postoperative Complications ; prevention & control ; Risk ; Rivaroxaban ; Thiophenes ; pharmacology ; Time Factors

Objective:To explore the role of clinical pharmacists in the use of antiplatelet drugs in the patients with PCI in periop-erative period in order to improve the clinical treatment effect and reduce the incidence of adverse drug reactions. Methods:According to the latest antiplatelet drug treatment guidelines and the related literatures, the causes of acute upper gastrointestinal bleeding induced by triple antiplatelet drugs were analyzed in one case of postoperative patients with PCI, and the rationality of the drug use and the treatment of bleeding were discussed, and the related suggestions were put forward for clinics. Results:In order to ensure the clinical safety and the rational use of drugs, the patients with high risk of bleeding and high thrombosis events should carefully select new anti-platelet drugs, and anti ischemic drugs with good efficacy and low bleeding risk were the first choices. Conclusion:In order to ensure medication safety and effectiveness, clinical pharmacists should actively participate in clinical rational drug use through giving relative suggestions and playing active roles in the rational use of antiplatelet drugs.