Adenocarcinoma, Papillary ; complications ; Adult ; Ear Neoplasms ; complications ; Endolymphatic Sac ; pathology ; Facial Paralysis ; etiology ; Humans ; Male

Objective:To summarize the perioperative nursing experience of a patient with hemophilia arthritis complicated with hepatitis C undergoing unilateral hip and knee arthroplasty at the same time.Methods:In August 2018, a patient with hemophilic arthritis complicated with hepatitis C was admitted to the first hospital of Lanzhou University. Preparations for health education, functional exercises, examination and evaluation before operation was made. Unilateral hip and knee arthroplasty were performed at the same time, strengthen the management of incisions and catheters after the operation, actively prevent complications, and guide patients to perform functional rehabilitation exercises under the conditions of good pain management and safe coagulation factor activity; pay attention to the nursing of coagulation factor replacement treatment in the whole perioperative period.Results:After careful nursing, no serious complications occurred during the patient's hospitalization, and the position and force line of the prosthesis were satisfactory by imaging examination before discharge.Conclusion:The perioperative care of this patient proved that the above-mentioned nursing measures are effective for hemophilic arthritis patients with hepatitis C undergoing unilateral hip and knee arthroplasty at the same time.

Objective To discuss the video-urodynamic characteristics and management in infra-sacral cord injured patients. Methods The video-urodynamic finding and managements in 169 patients was reviewed. They were followed up for 2 years. Results Detrusor areflexia was found in 76.33% (129/169) patients, among them there were 27.22% (46/169) patients appeared hyper-compliance, and 7.10% (12/169) patients appeared reflux. The video-urodynamic characteristics showed over activity and low-compliance in 12.43% (21/169) patients, including reflux in 5 cases. Different management was chosen according to the video-urodynamic examination. No special complication was observed after 2 years follow-up. Conclusion The majority patients with infra-sacral cord injury appeared detrusor areflexia and hyper-compliance. Special management according to the video-urodynamic characteristics is important for protecting upper urinary tract and preventing urinary system infection.

Objective To analyse the clinical efficacy of methotrexate (MTX) combined with intrauterine embryo sac garrotte injection in the treatment of cesarean scar pregnancy (CSP), and discuss its clinical significance. Methods A total of 77 patients with CSP treated in our hospital during June 2013 to December 2016 were selected in this study. Forty patients treated with embryo sac destruction and methotrexate injection were included in the observation group, while 37 cases treated by uterine artery embolization combined with curettage were used as the control group. The time of vaginal bleeding, the time of postoperative blood level of human chorionic gonadotropin (HCG) returned to the normal level, average hospitalization cost and the curative rate were recorded in two groups. All patients were followed up by the outpatient visit. Results In the observation group, the vaginal bleeding time [(22.1±6.7) days vs. (29.5±10.8) days] and treatment cost [(8774.2 ± 714.5) yuan vs. (15258.3 ± 1084.2) yuan] were less than those of the control group (P<0.001). There were no significant differences in the recovery time of HCG [(26.4±9.0) days vs. (25.1±10.4) days] and treatment success rate (87.5%vs. 91.9%) between the two groups (P>0.05). No bleeding or threatened rupture of scar were found in two groups of patients. Conclusion In this study, we take the embryo sac puncture combined with methotrexate injection in the treatment of scar pregnancy. This method has the advantages of low operative difficulty, definite clinical curative effect and low cost

Coronary Vessel Anomalies ; diagnosis ; Diagnostic Imaging ; Humans ; Myocardial Bridging

As one of the major geriatric syndromes,frailty exerts adverse effects on life expectancy and quality of life of the elderly.Because of its importance,a number of methods and tools have been introduced for the assessment of frailty.Malnutrition,as an independent risk factor,interacts with frailty and is involved in its progression.This article reviews recent studies on frailty and malnutrition.

Objective To investigate the risk factors of postoperative complications in spinal tuberculosis surgery,and try to find a way to improve the results of perioperative management and reduce or avoid the postoperative complications.Methods All of 172 cases of spinal tuberculosis who were treated by surgery from February 2005 to January 2013 in orthopedic department of Zhongshan hospital,Fudan University were retrospectively analyzed.There were 88 males and 84 females,whose average age was 50.9± 18.7y (18-84y).Among them 98 cases got cold abscess,and 56 cases had tuberculosis poisoning symptoms.The lesions located mostly in thoracic spine (112/172,65.1％) and lumbar spine (40/172,23.3％),while rarely in cervical or sacral spine.2 intervertebral spaces were involved in 116 cases (67.4％),more than 2 intervertebral spaces were involved in 32 cases (18.6％),and single intervertebral space were involved in the rest cases (14.0％).38 cases were treated through single anterior approach,54 cases were treated by anterior-posterior surgical approach,and single posterior approach was performed in 80 cases.58 cases were suffered from neurological dysfunction.All the postoperative complications and related clinical parameters during hospitalization period were collected and analyzed with SPSS software.Each clinical parameter was analyzed with univariate analysis to find the factors related to postoperative complications,and then the related factors were analyzed by multivariate regression analysis.Results All of 172 patients were included and 41.9％ (72/172) of the patients suffered from postoperative complications.System complications were the most common (33.7％,58/172).The rates of local complications were 10.5％ (18/172).Univariate analysis showed that the lesion site,value of hemoglobin,electrolyte disturbances,postoperative ASIA score and blood loss were related with postoperative complications.Posterior approach related with local complications.Multivariate regression analysis showed that preoperative hemoglobin ＜100 g/L,poor postoperative ASIA scores and long period of preoperative anti-TB treatment (＞28 days) were related with the system or local postoperative complications.Conclusion Patients with anemia (hemoglobin ＜ 100g/L),poor postoperative neurological function and long period of preoperative anti-TB treatment could take more risks of the postoperative complications.

In this paper, the authors analyzed the clinical features and the psychological characteristics of pa-tients with vitiligo: nervousness and inferiority, urgent treatment, high expectation , disappointed feelings of the failtreatment. Aimed at these psychological problems, the medical ethics requirements in the process of diagnosis and treatment were proposed:respect for the patient, protect of the patient′s privacy, patient communication and regular follow-up and health education.

Objective To research the functional and structural change in TgAP-PswePS1 transgenic mice after intensive light exposure insult.Methods APPswe/PS1 transgenic mice at the age of 6 months old were grouped for experiments,the transgenic mice were replaced by light insult device for 6 months,while the control mice were kept in normal conditions.After 6 months light exposure,the eyes of control and experimental mice were examined with electroretinography (ERG).The retinal morphology change was investigated with H&E staining.All of the results were quantified and statistically analyzed.Results In the control group,the amplitudes of a and b wave in the rod response were (18.33 ±3.53) μV and (107.58 ± 14.72) μV,while (64.80 ±7.57) μV and (178.76 ± 14.47) μV for the amplitudes of a and b wave in the maximum response;After treated by 6 months of intensive light exposure,in experimental group mice,the amplitudes of a and b wave in the rod response were (17.92 ±4.89) μV and (21.83 ± 5.51) μV;While in the maximum response a striking decrease was detected with a wave (18.23 ±4.44) μV and b wave (24.50 ± 4.49) μV,by compared with control group,the difference were statistical significant (all P ＜ 0.05).Histopathological analysis found significant loss of outer nuclear layer,photoreceptor out segment,whereas controls remained little change in the retina.And the retinal thickness decreased significantly from (181.32 ± 13.47) μm in control group to (102.34 ±9.38) μm after light insults in experimental group,the difference was statistical significant (P =0.017).Conclusion Intensive light exposure can cause the retinal structural and functional disorder in the AP-Pswe/PS1 transgenic mouse.

Objective To research the choroidal neovascularization (CNV)in TgAPPswePS1 transgenic mice after intensive light exposure injury.Methods Twenty TgAPPswe/PS1 transgenic mice at the age of 6 months were grouped for experiments.The treated groups of 12 mice were treated by a source of 10 000 lux cool full spectrum light for 6 months,12 hours per day;While the control groups of 8 mice were kept in normal conditions.The mice eyes of the experimental group and control group were examined with HE/Toluidin blue staining,the retinal structure was observed,and the number of CNV was counted.The expression of VEGF and Aβ were examined with immunofluorescence on the retinal pigment epithelial (RPE) flat mount.All of the results were quantified and statistically analyzed.Results After treated by 6 months of intensive light exposure in the experimental group,histopathological analysis has found significant loss of outer nuclear layer/photoreceptor out segment and outer plexiform layer as compared with the control group;At the same time,abnormal hypo-and hyper-pigmentation,vacuoles and disruption in the RPE layer,remarkable CNV were found in the experiment group by Toluidin blue staining,and the incidence of CNV was 18.75％.The VEGF expression domenstrated.a diffusive and deposition pattern along the neovessels which showed a significant increase of (6.59 ± 1.14) fold changes as compared with the control group.The difference was statistical significant (P ＜ 0.05).Then the Aβ deposits were positive expressed in the RPE layers after intensive light exposure treatment,and pathological deposition of Aβ in the RPE showed plaque like displayed by confocal Z-stack microscopy,and the drusenoid Aβ deposits were found alone with the neovessels on the RPE flat mount.The deposition of Aβ protein increased with (6.45 ± 2.93) fold changes as compared with the control group,and the difference was statistical significant.Conclusion CNV with degenerative changes in the outer retina can be induced by intensive light exposure in the APPswe/PS1 transgenic mouse.These results suggest that an Alzheimer's transgenic animal model might be an alternative animal model for CNV if combined with intensive light exposure.