BACKGROUND: Total hip arthroplasty is a commonly used treatment, but it is difficult to accurately determine the position of the pelvis, which is easy to cause pelvic displacement postoperatively. Additionally, the implant is likely to present with angle deviation, and the precise location and direction of prosthesis is difficult to identify.OBJECTIVE: To study the position and biomechanical characteristics of prosthesis in total hip arthroplasty.METHODS: (1) One male volunteer received CT examination, and a finite element model of the pelvic was established.Three acetabular placement positions (abduction angles of 0°, 20° and 25° combined with anteversion angles of 35°, 15°and 10°) were used to perform total hip arthroplasty, and the peak von Mises stress was detected under a load of 240 N.(2) Six cadaver specimens were collected and received the same interventions with the former experiment, and the stress changes at the bone cortex surrounding femoral shaft and acetabular anterior and posterior wall were measured using resistance strain technology.RESULTS AND CONCLUSION: (1) The peak von Mises stress in the acetabulum at abduction angle of 25° combined with anteversion angle of 10° increased by 25.7%. The peak von Mises stress in the acetabular cup at abduction angles of 0°, 20° and 25° combined with anteversion angles of 35°,15° and 10° was 135.21, 68.3 and 134.2 MPa, respectively.The peak von Mises stress in the lining at abduction angles of 0°, 20° and 25° combined with anteversion angles of 35°,15° and 10° was 6.8, 3.9 and 6.7 MPa, respectively. The peak von Mises stress in the femoral shaft at abduction angles of 0°, 20° and 25° combined with anteversion angles of 35°,15° and 10° was 127.1, 100.2 and 128.2 MPa,respectively. (2) The stress at the bone cortex surrounding femoral shaft and acetabular anterior and posterior wall at abduction angles of 0° and 25° combined with anteversion angles of 35° and 10° was significantly higher than that at abduction angle of 20° combined with anteversion angle of 15°. To conclude, an abduction angle of 20° combined with anteversion angle of 15° is conductive for functional recovery of the joint.

Objective To analyze the water quality of the swimming pools in Yinchuan City from 2002 to 2005 and to know the sanitary states of the swimming pools, so as to prevent water-born infection effectually. Methods pH, turbidity, carbamide, free chlorine residual, coli group and total bacterial count in the water samples were determined. Results 664 water samples were tested, 252 water samples were qualified(the rate was 37.93%). From 2002 to 2005, the rates of up to standard were 29.08%, 22.83%, 40.48% and 50.00%, the difference was significant(?2=30.74, P

Objective To study the effects of ephedrine and phenylepbedrine for maintenance of arterial pressure during combined spinai/epidural anesthesia (CSEA) for caesarean section. Methods Forty patients, ASA grade Ⅰ - Ⅱ, who were scheduled for caesarean section by CSEA were randomly divided into two groups, when patients were hypotension, phenylephedrine 100 μg (group P, 20 cases ) or ephedrine 10 mg (group E, 20 cases). The variety of blood pressure (Bp), heart rate (HR) and oxyhemoglobin saturation (SpO2) were monitored; recorded before anesthesia (T0), at 15 min after anesthesia (T1), fetuses were taken out of uterus (T2) and at the end of operation (T3); umbilical arterial blood gas analysis was monitored; neonatal Apgar score was investigated. Results Umbilical arterial blood gas analysis of pH,PaO2, PaCO2, HCO3-, SaO2 were normal in two groups, there were no significant difference in PaO2, PaCO2 and SaO2 between two groups, but pH and HCO3- in group P were higher than those in group E [7.38±0.07 vs7.30±0.02 and (21.5±3.4) mmol/L vs (19.3±3.3) mmol/L] (P <0.05). There were no significant difference in Apgar score and Bp between two groups. Compared with group P, the HR in group E was increased obviously at T1 and T2 (P < 0.05). Conclusion Phenylephedrine is the vasopresser that most closely meets the criteria for the best vasopressor to use in obstetric patients.

Objective To investigate early reduction of the dose of immunosuppressive drug after allogeneic peripheral blood stem cell transplantation(allo-PBSCT)for patients with refractory or relapsed leukemia.Methods Between Janaury 2004 and December 2006,15 patients with relapsed or refractory leukemia in Department of Hematology,the First Affiliated Hospital,Sun Yat-Sen University and Institute of Hematology & Blood Diseases Hospital,CAMS & PUMC,received allo-PBSCT from their relatives,12 from HLA-identical siblings.The preparative regimens included BuCy and TBICy with or without cytarabine.Cyclosporine A(CsA)or tacrolimus was used for graft-versus-host disease(GVHD)prophylaxis,with rapid decreasing starting on day 30 of post transplant if no GVHD appeared in receipts of matched sibling tranplantation.Results(1)Faster engraftment was achieved in all patients.Grade Ⅰ~Ⅱ acute GVHD appeared in 5 patients.Chronic GVHD occured in 7 of 11 evaluable patients.(2)Of 9 patients with an lower CsA or tacrolimus dosage,only 1 developed grade Ⅰ acute GVHD,4 chronic GVHD,2 extramedullary relapse.(3)After a median follow-up of 328 days,8 patients has leukemia-free-survival(LFS),4 relapsed,and only 1 had transplantation-related mortality(TRM)in the first 3 months post-transplant.The estimated LFS at 1 year and 2 years was 51% and 25%,respectively.Conclusion Patients with advanced leukemia might benefit from allo-PBSCT with significant lower treatment failure incidence.Dose reductions of CsA and tacrolimus in early transplant might enhance graft-versus-leukemia effect,and improve long-term LFS.

Objective To investigate MRI features of heat stroke (HS) and 1H-MRS in monitoring clinical outcome.Methods Six cases(4 males,2 females) of HS patients,aged 43-75 years old were retrospectively studied.The patients were divided into 4 severe cases (2 cases with coma for 4 hours,2 patients with persistent coma) and 2 moderate cases according to initial Glasgow coma scale (GCS) at the time of hospital admission.All patients underwent T1WI,T2WI,FLAIR,DWI,SWI,multi voxel 1H-MRS scans and the ratios of NAA/Cr,Cho/Cr,and NAA/Cho were calculated.One case of severe coma died on the next day.Follow-up imaging and brain 1H-MRS were performed on other 5 patients on the 7th and 15th day after the first examination.The imaging results were compared with clinical outcome.Results MRI features of HS for severe coma patients were iso-intensity on T1WI,hyper-intensity on T2WI,FLAIR and DWI,heterogeneous signal intensity on ADC.The infratentorial lesions distributed in the cerebellum,dentate nucleus and cerebellar arm (3 cases),and the supratentorial lesions distributed in the parahippocampal gyrus (2 cases),parietal lobe (2 cases),and temporal lobe (1 cases).The lesions could be multiple,and the cerebellum and the parahippocampal gyrus were most common involved.SWI showed focal hemorrhage in 2 cases,which located in the brainstem and parietal lobe.No obvious MRI abnormality was found in 2 cases of moderate coma patients.The ratios of NAA/Cr,Cho/Cr,and NAA/Cho for severe coma patients were 0.67 ±0.09,0.94 ±0.16 and 0.70±0.12,respectively,which for moderate coma patients were 0.87±0.12,0.95±0.13,and 0.94±0.08,respectively.The NAA/Cr and NAA/Cho ratios decreased and Cho/Cr mild decreased in the severe coma patients when compared with the moderate coma patients.One patient with persistent coma had expanded lesions on follow-up study.NAA/Cr,NAA/Cho and Cho/Cr were 0.63± 0.07,0.67 ±0.10,and 0.96 ±0.05,respectively.Two cases had smaller lesions on follow-up study with NAA/Cr and NAA/Cho ratio increased,which were 1.02±0.13 and 0.96±0.11,respectively.GCS was turned to 14.NAA/Cr and NAA/Cho for moderate coma patients were 1.17±0.10 and 1.21 ±0.07,respectively.Conclusions Severe HS patients present with cerebral edema and hemorrhage.1H-MRS can be an important index for monitoring the severity of HS.The longer the duration of coma,the worse prognosis may happen.

Objective To establish a semi-quantitative method for measurement of HCV RNA by use of primers and probe, which was sensitive and designed by ourselves, a new europium fluorescent chelate BHHCT. Methods 44 serum samples of HCV infected patients and 20 samples of the healthy people were collected. HCV RNA in serum sample was extracted by HCV fluorescence PCR diagnostic kit produced by Zhongshan University DAAN Gene Co Ltd, and amplified by RT-PCR in which one PCR primer was pre-labeled with biotin. The amplified products were hybridized with capture probes pre-fixed on the microplate. The biotin in the amplified products was conjugated with europium labeled streptavidin. So europium was linked to the target DNA. Then the fluorescent of europium was measured. Results The linear range of this assay was 10 - 10 copies/ml. Both sensitivity and specificity were 100%. Conclusion Europium labeled RT-PCR assay is a sensitive, specific, fast and non-radioactive contaminant method for the measurement of HCV RNA.

Objective To explore the therapeutic effects and mechanism of bone marrow mesenchymal stem cells (MSC) transplantation in mice autoimmune hepatitis (AIH).Methods AIH model was established in 44 C57BL/6 mice,which were induced by homologous series liver-specific antigen S-100 and Freund's complete adjuvant.After modeling,six mice were collected for AIH model confirming.The other 38 mice were divided into three groups.Fourteen mice of MSC transplantation group (group A) were treated by MSC tail vein injection,12 mice of dexamethasone (DXM) group (group B) were treated by DXM intraperitoneal injection,and 12 mice of PBS control group (group C) received phosphate buffer saline (PBS) intraperitoneal injection.Eighteen mice of healthy control group (group D) weren't modeled and received no treatment.At the 5th and 9th week,the mice weights and serum alanine aminotransferase (ALT) level were tested,mice liver tissues of each group were estimated by pathological examination and Knodell scoring,and spleen T lymphocytes of mice were isolated for proliferation-inhibition examination.The data were analyzed by rank sum test,ANOVA and t test.Results After treatment,mice weights of both group A and B showed upward trend (F=15.678,P＜0.01; F=3.730,P=0.037).Before and after treatment,there was no significant difference in group C (P＞0.05).At the 5th and 9th week,the ALT level of group A and B gradually decreased,there was statistical significance between the time points (F=20.267,P＜0.01; F=4.277,P=0.034).Before and after treatment,there was no significant difference in ALT level of group C (P＞0.05).At the 5th and 9th week,the degree of mice serum ALT reduction of group A was larger than that of group B,and the difference was statistically significant (t=3.566 and 3.218,both P＜0.05).At the 5th and 9th week,the Kondell scores of group A and B gradually decreased,there was statistical significance between the time points (F=8.070,P=0.003; F=6.547,P=0.009).Before and after treatment,there was no significant difference in Kondell scores of group C (P＞0.05).At the 9th week,there was statistical significance in Kondell scores among group A,group B and group C (F =4.477,P =0.029).The in vitro spleen lymphocytes proliferation-inhibition experiment demonstrated that the supernatant of MSC could significantly inhibit the proliferation of T lymphocytes stimulated by S-100 antigen and concanavalin A,the absorbance values were0.267±0.167 vs.0.217±0.128 and0.165±0.187 vs.0.082±0.051 respectively,the differences were statistically significant (t =7.187 and 4.602,both P＜ 0.01).Conclusion MSC transplantation may play a therapeutic role in mice AIH through inhibiting T lymphocyte proliferation.

Objective:To investigate the expression and clinical relevance of micro RNA (miR)-324-5p in pancreatic cancer tissues, and to explore the effects and potential mechanisms of miR-324-5p on the proliferation and migration of pancreatic cancer cells.Methods:Real-time quantitative PCR was used to detect the expression of miR-324-5p in 34 pairs of pancreatic cancer and adjacent normal tissues resected at Peking University First Hospital from October 2018 to September 2019. The correlations between miR-324-5p expression and clinicopathological characteristics and prognosis of pancreatic cancer were analyzed using data from the Cancer Genome Atlas (TCGA) database. Real-time PCR was used to detect the expression of miR-324-5p in pancreatic cancer cell lines, and PANC-1 cell was used for functional study by overexpressing miR-324-5p via mimic transfection. CCK8 assay was used to evaluate cell proliferation. Both transwell and scratch wound healing assay were used to assess the cancer cell migration ability. Related proteins were detected by Western blot. The potential downstream target genes of miR-324-5p were selected using data from miRNA target genes predicted webs, in combination with functional analysis and their expressional correlation with miR-324-5p.Results:Data from TCGA database showed that the expression of miR-324-5p in tumor tissues was significantly lower than that in normal pancreatic tissues. And low level of miR-324-5p in pancreatic cancer was correlated with poor prognosis. Analysis of 34 pairs pancreatic cancer and adjacent normal tissues showed that miR-324-5p expression in tumor tissues (11.7±2.0) was significantly lower than that in adjacent normal tissues (70.9±14.4), and the pancreatic cancer patients who had the nerve invasion cancer showed low level of miR-324-5p (82.1%, 23/28) was significantly higher than that patients with high level of miR-324-5p (33.3%, 2/6). The expression of miR-324-5p in human pancreatic cancer cell line was also significantly lower than that in normal pancreatic ductal cells. CCK-8 assay showed that the proliferation ability of PANC-1 cell was significantly decreased when miR-324-5p was overexpressed. Transwell and wound healing assays showed that the capabilities of vertical migration and the horizontal movement were significantly inhibited in PANC-1 cell with miR-324-5p overexpressed [(30.11±5.2) and (174.6±27.0) μm, respectively] than those in control groups [(63.6±4.2) and (458.3±22.3) μm, respectively]. Moreover, Western blots showed a significant overexpression of miR-324-5p inhibited epithelial-mesenchymal transition (EMT). According to the data from miRNA target genes prediction and the functional analysis we found KLF3, MGAT3, PBX1 and ZNRF2 were considered as the potential downstream target genes of miR-324-5p.Conclusions:Our results indicated that miR-324-5p is lowly expressed and acts as the tumor suppressor gene in pancreatic cancer, and low level of miR-324-5p is correlated to a higher rate of nerve invasion and poor prognosis. In human pancreatic cancer cell, miR-324-5p may regulate EMT by directly inhibiting target genes such as KLF3, MGAT3, PBX1, ZNRF2, which in turn suppresses cancer cell proliferation and migration.

Objective To investigate the application of carotid artery resection and reconstruction in surgical management of thyroid carcinoma with carotid artery involvement.Methods We conducted a retrospective cohort study involving 10 patients whose common carotid arteries were invaded by thyroid carcinoma.All patients underwent tumor en bloc resection and carotid arteries reconstruction.Patients were evaluated by muhidisciplinary team and surgeries were cooperated by general surgeons,orthopedists and vascular surgeons.The perioperative complications and surgical outcomes were also recorded and analyzed.Results No patient had complications of central nervous system.One patient suffered Horner syndrome and one presented hoarseness postoperative.Two patients had wound infection,two patients presented carcinoma recurrence and two patients presented distant metastasis during the follow-up.Conclusion En bloc resection of tumor and carotid artery reconstruction is a feasible modality in treatment of thyroid carcinoma with carotid artery invasion.

Objective This study was designed to evaluate the safety ,tolerability and efficacy of intravenous caspofungin for treatment of invasive candidiasis and esophageal candidiasis in Chinese adults .Methods This was a non-controlled ,multicenter ,candidiasis .All the 63 patients were included in the safety set (SS) and the full analysis set (FAS) .In the SS ,19 SAEs occurred in 14 patients .All these SAEs were unrelated to caspofungin .There were 73 caspofungin-related non-serious AEs in 31 patients (49 .2% ) .Five patients (7 .9% ) had both clinical AEs and laboratory abnormalities .Eight patients (12 .7% ) had clinical AEs (mainly rashes) ,and 27 patients (42 .9% ) had laboratory abnormalities ,mainly increases in liver enzymes alanine transaminase and aspartate transaminase and reduction in blood potassium .About 91 .7% of the clinical AEs were mild to moderate .Treatment was discontinued in 1 patient (1 .6% ,1/63) due to AEs .The overall efficacy was 58 .1% (36/62) in the FAS and 70 .0% (35/70) in the per-protocol set (PPS) .In the FAS ,the therapeutic efficacy was 57 .6% (34/59) for invasive candidiasis and 66 .7% (2/3) for esophageal candidiasis .In the PPS , the therapeutic efficacy was 68 .8% (33/48 ) for invasive candidiasis and 100% (3/3 ) for esophageal candidiasis .Conclusions The AEs of caspofungin were mostly mild to moderate in the treatment of invasive candidiasis and esophageal candidiasis in Chinese adults .Only one patient terminated therapy due to drug-related AE .Caspofungin is safe and effective for the treatment of invasive candidiasis and esophageal candidiasis in Chinese adults .