Clinical data of 448 patients aged ≥60 years with osteoporotic hip fractures admitted in Shanghai Huashan Hospital between January 2010 and December 2014 were retrospectively analyzed.Among 448 cases,there were 143 males and 305 females;196 cases aged 80-89 years (43.8％) and 137 cases aged 70-79 years (30.6％);304 cases of femoral neck fracture (67.9％) and 144 cases of intertrochanteric femoral fracture (32.1％);the fractures caused by fall in 328 cases (73.2％) and comorbidity with hypertension and diabetes mellitus in 415 cases (92.6％).Two hundred and sixty eight patients were followed up for 2 years,among whom re-fractures occurred in 17 cases.The study indicates that health education is important for prevention of osteoporotic fractures in elderly people.

Hematopoietic Stem Cell Transplantation ; Hepatocyte Growth Factor ; pharmacology ; Humans ; Immunologic Factors ; pharmacology ; Postoperative Period

0.05);the lung′s rale improvement was significant(diffe-)rent(?~2=4.75 P

Objective:To explore the changes of neuron-specific enolase (NSE) and S-100β protein (S-100β) during perioperative period in infants undergoing living liver transplantation and examine the effect of brain injury.Methods:From January 2015 to January 2016 in Department of Anesthesiology First Central Clinical College Tianjin Medical University, study group was composed of forty infants of congenital biliary atresia with an age range of (4-12) months, a body weight of (4-10) kg and American Society of Anesthesiologists (ASA) class Ⅲ/Ⅳ. Another 40 infants undergoing general surgery were selected as control group. In study group, blood samples were harvested from central vein pre-operation (T0), before skin incision (T1), 30 min after anhepatic phase (T2), 1 h of neohepatic phase (T3) and 24h after hepato-reperfusion (T4). In control group, blood samples were collected at pre-operation (T0) and 24 h post-operation (T4). Serum levels of S-100β, NSE, heart rate (HR), mean arterial blood pressure (MAP), central venous pressure (CVP) and bispectral index (BIS) were monitored at T1-4 and end of surgery. All children were assessed by Bayley Scale of Infant Development (BSID) at Day 1 pre-operation and 2/4 weeks post-operation for observing mental and motor development status. The results were described with mental development index (MDI) and psychomotor development index (PDI). Pediatric anesthesia emergence delirium (PAED) was employed for evaluating the severity of delirium during the recovery stage at 30 min and 2/4h post-extubation.Results:In study group, serum levels of S-100β and NSE changed significantly during non-hepatic and neohepatic reperfusion phases. After inferior vena cava occlusion, serum concentrations of S-100β and NSE spiked ( P<0.05) and gradually recovered during neohepatic reperfusion period ( P<0.05). No significant inter-group difference existed in serum S-100β or NSE at T4 ( P>0.05). In study group, as compared with Day 1 pre-operation, MDI/PDI decreased at Week 2 post-operation ( P<0.05) and increased from Month 1 post-operation ( P<0.05). Both MDI and PDI were lower than control group before and at Week 2 post-operation ( P<0.05). MDI/PDI of study group basically reached the preoperative level at Month 1 post-operation ( P<0.05). In control group, no significant difference existed in MDI/PDI at Day 1 pre-operation and Week 2/4 post-operation ( P>0.05). In study group, the delirium rate was up to 30% post-extubation and decreased at 2/4h post-extubation. In control group, the incidence of delirium was low at 30 min and 2/4h post-extubation ( P<0.05). Conclusions:Perioperative evaluations of serum levels of NSE and S-100β are significant for predicting the postoperative onsets of delirium and cognitive impairment in children with living donor liver transplantation.

Child ; Child, Preschool ; Cross Infection ; epidemiology ; etiology ; Hospitals, General ; Humans ; Infant ; Infant, Newborn ; Length of Stay ; Retrospective Studies

Coccidioides ; Coccidioidomycosis ; pathology ; Humans ; Infant ; Male

Adult ; Brachial Plexus ; Female ; Humans ; Male ; Middle Aged ; Neurilemmoma ; surgery ; Treatment Outcome

Objective To investigate the effects of preoperative jaundice relieving on hemihepatectomy of hilar cholangiocarcinoma.Methods The clinical data of 18 patients who received preoperative percutaneous transhepatic cholangiography and drainage (PTCD) or endoscopic nasobiliary drainage (ENBD) before hemihepatectomy at the Tongji Hospital of Huazhong University of Science and Technology from January 2007 to January 2012 were retrospectively analyzed.The condition of the 18 patients (jaundice relieving group) was compared with that of 24 patients (non-jaundice relieving group) who did not receive PTCD or ENBD before hemihepatectomy.The differences in the pre-and postoperative blood loss,blood transfusion,operation time and postoperative incidence of complications between the 2 groups were analyzed.All data were analyzed using the t test or chi-square test.Results After PTCD or ENBD,the levels of total bilirubin (TBil),direct bilirubin (DBil),alanine aminotransferase (ALT) were (27 ± 5) μmol/L,(22 ± 6) μmol/L and (52 ± 42) U/L,which were significantly lower than (287 ± 120)μmol/L,(212 ± 86)μmol/L,and (267 ± 180)U/L before PTCD or ENBD in the jaundice relieving group (t =4.33,6.61,4.19,P ＜0.05).In the jaundice relieving group,left hemihepatectomy was performed on 14 patients,and right hemihepatectomy on 4 patients,and the radical resection rate was 16/18.In the nonjaundice relieving group,left hemihepatectomy was performed on 11 patients,and right hemihepatectomy on 13 patients,and the radical resection rate was 83.3％ (20/24).There was no significant difference in the radical resection rate between the 2 groups (x2 =1.09,P ＞ 0.05).The operation time,volume of intraoperative blood loss,volume of blood transfusion were (5.0 ± 0.8) hours,(562 ± 207) ml and (430 ± 317) ml in the jaundice relieving group,and (6.3 ± 1.5)hours,(815 ± 463)ml and (750 ± 146)ml in the non-jaundice relieving group,with significant differences between the 2 groups (t =4.77,7.80,4.65,P ＜ 0.05).The incidences of postoperative complications,bleeding and postoperative hepatic failure were 3/18,1/18 and 1/18 in the jaundice relieving group,and 75.0％ (18/24),33.3％ (8/24) and 33.3％ (8/24) in the non-jaundice relieving group,with significant differences between the 2 groups (x2=5.14,7.58,7.58,P ＜ 0.05).Conclusion Preoperative jaundice relieving could shorten the operation time and reduce the volume of intraoperative blood loss and the incidence of postoperative complications.

Objective To explore the risk factors of the recurrence of ischemic stroke and to supply theoretical basis for secondary prevention.Methods 612 patients with ischemic stroke were enrolled in the study and they were followed-up for 2 years to record the stroke recurrence.According to whether the recurrent stroke occurred,all the patients were divided into the recurrent group and the non-recurrent group.Logistic regression model was used to analyze the risk factors.Results Of 612 patients,90 patients suffered from recurrent stroke and the recurrence rate after 2 years was 14.7％.In the recurrent group,age,smoking,hypertension,diabetes,fibrillation atrial history and homocysteine level were significantly higher than those in non-recurrent group (P ＜ 0.05),compliance of anti-platelet drugs was significantly lower than that in non-recurrent group (P ＜ 0.01).Multivariate analysis suggested that age,smoking,hypertension,diabetes,atrial fibrillation history,homocysteine level and compliance of anti-platelet drugs were associated with recurrence of ischemic stroke (OR value =11.14,47.38,53.11,111.12,53.11,40.98,90.12,all P ＜ 0.05).Conclusion Age,smoking,hypertension,diabetes,atrial fibrillation history,homocysteine level and compliance of anti-platelet drugs are the independent risk factors of recurrent stroke.To enhance the interference of these risk factors are helpful for preventing the recurrence of stroke.

Objectives To investigate the characteristics of neural invasion of pancreatic cancer as well as its relationship with other clinicopathological factors. Methods The neural invasion situation of 491 cases of ductal adenocarcinoma and other 22 pancreatic malignancies, 41 cases of benign tumor of pancreas and 21 cases of chronic pancreatitis was observed under light microscope, and its relationship with other clinicopathological factors was analyzed. Results The rate of neural invasion in ductal adenocarcinoma (74%) was much higher than in other types of pancreatic neoplasm (23% ,P ＜ 0.01). Pancreatic ductal adenocarcinoma cell often invaded through peripheral nerve membrane into inner nerve fiber bundle, sometimes even invaded the whole cross-sectional nerve fiber. But neural invasion was not associated with differentiation of the tumor. The occurrence of chronic inflammation in the para-tumoral pancreas (52%) was also higher than that in other types of malignant (14%) or benign lesions (15% ,P ＜0.01). Lymphocytes neural invasion rate in pancreatic ductal adenocarcinoma was 65%, which were significantly higher than those in other types of malignant (36%) or benign lesions (22%, P ＜ 0.01). Neural invasion rate in pancreatic ductal adenocarcinoma was associated with paratumoral chronic pancreatic inflammation and lymphocytes neural invasion, but not with lymph node metastasis. Conclusions Neural invasion was characteristic biological behavior in pancreatic ductal adenocarcinoma.