Child ; Hemophilia A ; diagnosis ; therapy ; Humans ; Practice Guidelines as Topic

ObjectiveTo approach the effect of early system rehabilitation training on the treatment of old age patients with proximal femoral fracture. Methods110 cases with surgical treatment of 75 years of age or older patients with proximal femoral fractures. according to whether receiving postoperative rehabilitation all the patients were divided into rehabilitation of 55 cases ,55 cases of control group;rehabilitation group were taken to early rehabilitation and training system, the control group received conventional rehabilitation. Clinical curative effect and complication rate of two groups were compared. ResultsAll patients were followed up for 8 months after operation,the rehabilitation group incidence of complications was 16.36 ％, significantly less than the control group, the incidence rate of 34.55％ ( P ＜ 0.05 ) ; functional evaluation of affected limb of rehabilitation group was 89.09 ％ higher than the 63.64％ in control group( P ＜0.05). ConclusionSurgical treatment of elderly hip fracture could decrease complication rate,improve functional evaluation of affected limb and clinical curative effect,could be used properly in clinic.

Objective To study if local implant of sustained-release 5-fluorouracil (5-Fu) and cisplatin (DDP) combined with radiotherapy can improve the treatment result of advanced and recurrent cervical cancer. Methods Forty-two patients with advanced (26 with stage Ⅲ) or recurrent (16) cervical cancer received local implant of sustained-release 5-Fu and DDP combined with radiotherapy ( group A), and 40 ( including 29 with stage Ⅲ and Ⅱ with recurrent cervical cancer) received radiotherapy alone during the same period as the control (group B). In group A, the pelvic external radiation was 45-55 Gy (including 25-30 Gy to the whole pelvis) over 6-7 weeks using 6-10 MV X-beams; 192Ir intracavity brachytherapy was 24-36 Gy in 4-6 fractions to the point "A", while the patients with Ⅲ A disease received 24-32 Gy in 3-4 fractions to 0.5 cm depth from the surface of vaginal mucosa; Sustained-release 5-Fu (200-400 rag) and DDP (40-80 mg) were implanted by puncture before and during the course of radiotherapy. In group B, the external beam radiation was as same as in group A, except that there was 8-12 Gy boosting to the local tumor in group B; The brachytherapy was 30-42 Gy to point "A", and those with ⅢA disease received 40-48 Gy to 0.5 cm depth from the surface of vaginal mucosa. Treatment efficacy and complications were compared be tween the two groups. Results In group A and B, the complete response rate (CR) was 69% and 30% (X2=12.50,P<0.01 ), respectively. The 3-year tumor-free survival rate was 62% and 25 % (X2=11.33,P<0.01), respectively. The time between the treatment and tumor response was shorter in group A then in group B. The toxicities of the bone marrow, the rectum and the bladder were similar between the two groups. Conclusions Local implant of sustained-release 5-Fu and DDP combined with radiotherapy could improve the results of patients with advanced or recurrent cervical cancer, without increasing the treatment toxicities.

Objective To evaluate and compare the advantages and disadvantages and the clinical applica- _ tion between abdominal hysterectomy (AH) and laparoscopically hysterectomy ( LAH) on the benign lesions of Non-prolapsed Uterus. Methods 400 patients with benign lesions of Non-prolapsed Uterus were divided into two groups. They were AH group (202 cases) and LAH group (198 cases). The effects of clinical treatment of the two groups were compared. Results In LAH group anal exhaust time,postoperative morbidity,length of stay were less than those in AH group,the difference was statistically significant(P <0. 05 ). The cost of LAH group was higher,and all symptoms were relieved after opreation. In LAH group,the average recovery time of the surgery to return to work time was(21 ± 7) d, but in AH group that was( 36 ± 8 ) d. The differences of recovery rime between two groups were statistically significantly ( P < 0.05). In two groups B-myoma were not found obvious by follow-up. Conclusion Different surgical patterns of hysterectomy had their distinctive advantages. The key point of a successful operation was to avoid complications of the operation.

Objective to compare the LMA and intubation in elderly patients with coronary heart disease hemedynamics,respiratory function and the impact of stress hormones.Methods 32 cases of elderly patients with coronary heart disease ASA II level under general anesthesia in the implementation of gastrointestinal surgery,were randomly divided into LMA group and endotracheal intubation group.Before the induction of anesthesia (T0),insert the LMA/endotracbeal tube before(T1),insert the LMA/tracheal tube immediately after(T2),insert the LMA/endotracbeal tube after 5 min(T3) ,10 min(T4),15 min(T5) and the skin incision,(T6) ,immediately after extubation (T7) record SBP,DBP,HR.Application BICORE monitor respiratory function 16 indicators,select T0,T3,T4,T5,T7 record at the suction tidal volume (,VTI),breath tidal volume (VTE),minute ventilation (VE),Inspiratory peak velocity(PIFR),peak expiratory flow rate (PEFR) ,peak inspiratory pressure(PIP) and the average airway resistance (RAWM).Patients in each group T0,T1,T2,T6,T7 at the application of high performance Iiqnid chromatography analysis of plasma epinephrine(AE),norepinephrine(NE),dopamine (DA) level.Results intubation group T2 at the SBP,DBP,HR significantly higher than the LMA group (P＜0.05) ;,VTI,VTE,VE,PIFR,PEFR,PIP and RAWM group there was no significant difference,AE,NE,DA in T2,T7,were significantly higher than the LMA group (P＜0.05).Conclusion Laryngeal Mask Airway general anesthesia for elderly patients with coronary heart disease is better than intubation,easy to maintain stable bemedynamics,the stress response minor,after the restoration of a smooth general anesthesia.

Objective:To compare the effects between estrogen and Prasterone(Dehydroepiandrosterone,DHEA) on improving atherosclerosis of ovariectomized rabbits. Methods: Thirty female New Zealand white rabbits of three months old were randomly divided into five groups: Group A: normal control;Group B: sham operation + high cholesterol feeding;Group C: ovariectomized + high cholesterol feeding;Group D: ovariectomized + high cholesterol feeding+ estradiol benzoate;Group E: ovariectomized + high cholesterol feeding+ DHEA.Twelve weeks later,all rabbits were sacrificed,the serum TC,TG,LDL-C,HDL-C,NO and estradiol levels were measured.The aortas and uterus were harvested for histomorphometrical evaluation with light and scanning electron microscope.The area ratios of atherosclerotic lesion to endothelium,and the thickness and area ratios of endothelium to the medium were determined by computer. Results: ①Following the treatment for 12 weeks,no significant difference was found in serum TC、LDL-C、HDL-C levels among four groups except in group A.②There were significant differences between the serum triglyceride(TC)levels of group D and group C.③The serum No levels of group D and group E were significantly higher than that of groupC.④The serum estradiol levels of group D and group E were significantly higher than that of groupC.⑤The area ratios of atherosclerotic lesion to endothelium and the thickness and area ratios of endothelium to the medium in group D and group E were significantly lower than that of group C.⑥Endometrial hyperplasia of group D was significant,while there was no such Phenomena in group E. Conclusion: Estrogen and DHEA can alleviate the early pathological changes of atherosclerosis of the ovariectomized rabbits,prevent and reduce the formation of atherosclerosis.

Objective To determine the impact of fear of progression on hope level of liver cancer patients. Methods A total of 186 liver cancer patients were recruited from two first-class hospitals in Suzhou by convenience sampling method. They were investigated with fear of progression questionnaire-short form and Herth hope index. The relationship between fear of progression of liver cancer patients and hope level was analyzed. Results The total score of hope level in liver cancer patients was (27.32±5.18) points. There were significant negative correlations between score of fear of progression of liver cancer patients and score of hope level. Regression analysis showed that the factor scores of fear of progression such as physical health and social family could explain 34.8%of the variance for hope level of liver cancer patients after controlling demographic variables. Conclusion Reducing the level of fear progression in patients with liver cancer will help raise the level of hope for patients with liver cancer.

Objective: To evaluate the effect of high-fat enteral nutrition on nutritional status and clinical prognosis in acute stroke patients. Methods: 56 cases of acute stroke patients were randomly divided into high-fat enteral nutrition(Supportan) group(high-fat group,28 cases) and standard enteral nutrition(Nutrison Fiber) group(control group,28 cases).All patients were treated by conventional therapy.The levels of blood glucose,hemoglobin,serum albumin,triglyceride,cholesterol,high density lipoprotein and low density lipoprotein,neurologic impairment score(NIHSS),and gastrointestinal side effects were measured before and at the 1st,the l0th,and the 21st day after enteral nutrition.Activity of daily living(ADL) was also observed at the 30th day after enteral nutrition. Results: The nutrition were not different between groups before EN.All nutrition indexes,except of blood glucose,were decreased at the l0th and the 21st day after enteral nutrition in control group.However,in high-fat group only the serum albumin level was decreased and the blood lipid level was maintained normally.The gastrointestinal side effects in two groups were not different.In high-fat group,NIHSS at the 21st day and ADL at the 30th day were markedly improved compared with those in control group(P

】 Objective To observe the effects and explore the mechanism of Huaxian Capsule (HXC) on pulmonary fibrosis. Methods 60 rats were divided into the normal group, the HXC group, the prednisone group, and the model group, 15 rats in each group. The pulmonary fibrosis model of rats was established with bleomycin. The experimental rats were sacrificed in batch on the 7th, 14th and 28th day for determining TIMP-1 protein and MMP-2 mRNA expression by immunohistochemistry and in situ hybridization respectively. The outcomes were compared between groups. Results It was showed that TIMP-1 protein and MMP-2 mRNA expression in different stage of pulmonary fibrosis increased significantly and continuously after modeling, showing significant difference in comparison between the model group and the normal group. After HXC treatment, the two indexes expressed weakly as compared with those in the model group, and showed significant difference to those in the model group on 14th and 28th. Conclusion HXC influence on the expression of TIMP-1 and MMP-2 mRNA in rats with pulmonary fibrosis. 【