Complications of artificial joint replacement include infection,aseptic loosening,prosthesis dislocation and breakage,and deep venous thrombosis. Type 2 diabetes mellitus induces capillary pathological changes,tissue blood supply decrease,leading to general and local resistance reduction. Type 2 diabetes mellitus is always complicated by heart,renal,or cerebrovascular complications,which contributes to high infection rate and frequent complications after artificial joint replacement. In addition,incidence of postoperative pulmonary infection and urinary tract infection is increased,and wound healing is delayed. Deep venous thrombosis is a common complication of diabetic patients following artificial joint replacement,which increases the complexity of perioperative treatment. Blood glucose instability may induce circulation function instability and increase indefinite factors during anesthesia. Therefore,blood glucose control is important to reduce risks in artificial joint replacement for diabetic patients.

OBJECTIVE:To study the interaction between bovine serum albumin(BSA)with lamivudine,efavirenz,tenofovir and its mechanism. METHODS:Fluorescence spectroscopy was used to determine the interaction between BSA with different con-centrations of lamivudine,efavirenz,tenofovir under different temperatures. The fluorescence intensity of them were determined re-spectively;quenching constant(KSV),apparent quenching constant(Kq),binding constant(KA),binding site(n),thermodynamic enthalpy change(ΔH),free energy diversification(ΔG)and entropy change(ΔS)were calculated according to Stern-Volmer equa-tion and so on. Molecular docking model of 3 drugs with BSA was established by using Sybyl 6.7 Flex X model. RESULTS:Kq for the interaction between 3 drugs with BSA were all higher than 2.0×1010 L/(mol·s),and were decreased with the increase of temper-ature;all n were close to 1,and thermodynamic functions ΔG<0,ΔS<0,ΔH<0. Molecular docking model showed that 3 drugs were mainly bound with BSA at Sudlow Ⅰ subdomain site. CONCLUSIONS:There are the interaction between 3 drugs with BSA;fluorescence quenching mainly manifests as static quenching;binding reaction belongs to spontaneous molecular action pro-cess;binding force mainly includes hydrogen bond and Van der Waals'force. The result of fluorescence experiment is consistent with those of molecular docking,and they complement each other.

The character, classification, scoring, diagnosis and treatment of abdominal injuries after the Wenchuan earthquake were analyzed based on the data collected in Chengdu and Dujiangyan. Most of the abdominal injuries were closed injury, and complicated with injuries in other organs. All the injured persons were classified into different groups according to the degree of injuries, so as to determine the optimal sequence of treatment. Open abdominal injuries were comparatively easy to diagnose, while the diagnosis of closed abdominal injuries was difficult and consisted of preoperative diagnosis and intraoperatire exploration. The principle of damage control surgery should be well followed in rescuing the persons with severe abdominal injuries.

Hepatectomy ; methods ; Humans ; Laparoscopy

Objective To study the application of ABCD3-I score in predicting the risk of early is-chemic stoke after transient ischemic attack (TIA) .Methods One hundred and eighty-two carotid TIA patients were divided into low risk group (n=40) ,moderate risk group (n=74)and high risk group (n=68) according to their ABCD2 ,ABCD3 and ABCD3-I scores .The incidence of ischemic stroke was observed within 7 days after TIA .Results The area under the ROC curve for ischemic stroke within 7 days after TIA was 0 .625 ,0 .713 and 0 .831 ,respectively .Twenty-seven patients (14 .8% ) developed ischemic stroke within 7 days after TIA .The incidence of ischemic stroke was significantly higher in moderate and high risk groups than in low risk group and in high risk group than in moderate risk group (6 .8% vs 0% ,32 .4% vs 0% ,32 .4% vs 6 .8% ,P< 0 .01) .The ABCD3-I socre was positively related with the incidence of ischemic stroke within 7 days after TIA (r=0 .486 ,P<0 .01) ,suggesting that ABCD3-I socre could significantly affect the incidence of ischemic stroke within 7 days after TIA (P<0 .05) .Conclusion ABCD3-I score can effectively predict the risk of early ischemic stroke after TIA ,and can thus be used in assessment and treat-ment of T IA .

Objective To explore the clinical manifestation,imaging features and treatment of primary lacri-mal gland epithelial tumor.Methods The clinical data of 25 cases with primary lacrimal gland epithelial tumors were retrospectively studied.Results All of 25 primary lacrimal gland epithelial tumor cases received surgical treatment. Fourteen primary orbital tumors cases were male and 11 cases were female.The mean age was 44 years old (ranged 23 to 65).The mean hospital stay was 12d(ranged 7 to 20).Among 25 primary lacrimal gland epithelial tumor cases, 11 cases were benign tumors which included 4 inflammatory pseudotumor,11 pleomorphic adenoma.Fourteen cases were malignant tumors which included 4 malignant pleomorphic adenoma,6 adenoid cystic carcinoma and 4 adenocar-cinoma.After opeation,visual acuity improved in 9 cases,unchanged 10 cases,decreased 6 cases.The patients were followed up for 16 -48 months(mean 27 months).There were 4 malignant tumors recurrence after operation and received radical operation.While 2 patients were lost and 2 patients died of tumor metastasis,the other 21 patients survived with tumor -free.Conclusion Primary lacrimal gland epithelial tumors have different clinical and imaging appearances.Combination of ultrasound,CT and MRI is important to ascertain the character,range and degree of primary lacrimal gland epithelial tumors.Surgical excision is the main and effective treatment for primary lacrimal gland epithelial tumors,while gamma knife treatment is safe and effective for malignant,unresectable,recurrences tumors.

Background and purpose:Osteopontin (OPN) is a secreted glyco-phosphoprotein, which is overex-pressed by numerous human cancers, invovled in tumor occurrence, development and prognosis. OPN up-regulates matrix metal proteases (MMPs) expression in a NF-κB-dependent fashion during extracellular matrix (ECM) invasion causing degradation of cell basement membrane and ECM leading to tumor invasion and metastasis. The aim of this study was to examine the protein level of OPN in a large number of tissue samples from patients with lung squamous cell carcinoma (SCC), and evaluate its potential clinical value.Methods:The OPN protein levels in 265 tumor tissue samples and corresponding 24 normal lung tissue samples were examined by immunohistochemical (IHC) analysis.Results:IHC results showed that the positive rate of OPN was 64.5% in the SCC tissues, which was significantly higher than that in normal alveoli tissues (29.2%,P<0.001). The positive rate of OPN expression in late stage (Ⅲ+Ⅳ) tissues was 78.4%, significantly higher than that in early stage (Ⅰ+Ⅱ) tissue(positive rate 54.5%,P<0.001). The positive rate of OPN expression in T3-4 stage (Ⅲ+Ⅳ) tissue was 76.9%, significantly higher than that in T1-2 stage tissue (positive rate 59.4%,P=0.007). The expression of OPN was signifcantly correlated with the status of lymph node metastasis (LNM). The positive rate in the tumor tissue with LNM was 73.4%, significantly higher than that without (positive rate 51.4%,P<0.001).Conclusion:The level of OPN protein was overexpressed in lung cancer tissues, involved in SCC carcinogenesis and LNM. It is indicated that OPN has an impor-tant reference value in diagnosis, prognosis and therapy of SCC.

Objective To investigate the clinical values of loop electrosurgical excision procedure (LEEP) in diagnosis and treatment of cervical intraepithelial neoplasia(CIN). Methods Fifty-two patients with cervical intraepithelial neoplasia underwent LEEP following cytology, colposcopy and multiple biopsies, were treated by LEEP. The cure rate, the operative time, bleeding volume and patients reaction of LEEP to the cervical intraepithelial neoplasia were investigated during the follow-up. Results The effective rate was 98.07 % in the patients treated by LEEP. The effective rate was 100 % in the patients in grade CIN Ⅰ or CIN Ⅱ by LEEP. No patients in grade CIN Ⅰ and Ⅱ had recurrence during the follow-up 1 year. The mean operative time was 7.8 minutes. The mean bleeding volume was 10 ml. No secondary bleeding and post-operative infection occurred. All these surgical specimens were checked successfully for pathology diagnosis. Conclusion The advantages to use the LEEP to manage cervical intraepithelial neoplasia include its simpleness to handle, short operative time,less bleeding, less vaginal discharge, safety, and high cure rate. LEEP can offer intact sample for pathological diagnosis. LEEP electrotome is a very ideal therapy for the cervical intraepithelial neoplasia, and can block the development of precancerosis to infiltrating carcinoma effectively.

Objective To investigate the effects of CO 2 pneumoperitoneum on circulation, P ET CO 2 and blood gas during laparoscopic hepatectomy. Methods Fourteen patients underwent laparoscopic hepatectomy with CO 2 pneumoperitoneum. The MAP, HR, CVP, P ET CO 2 , airway pressure and blood gas were monitored respectively before, 30min, 60min, 120min after pneumoperitoneum, and 10min and 30min after deflation of the abdomen. Results The HR, P ET CO 2 , PaCO 2 , and plood K + were significantly higher 30min after pneumoperitoneum compared with the values before pneumoperitoneum (P

OBJECTIVE According to the development of nosocomial infection management in China,we design a series of nosocomial infection surveillance and management system,in order to work effectively in real time to control nosocomial infection outbreak,standardly collecting and analyzing the surveillance data of the critical department/area and risk factors for nosocomial infection,so a scientific management for nosocomial infection can be realized.METHODS Adopting C/S framework,the backstage supporter adopted the large-scale database of SQL SERVER 2000 edition,the front application program used PowerBuilder7 programming.The application software where collected all data about nosocomial infection information was integrated into the each work station of the information system,in order to form nosocomial infection surveillance and management network related to any department of the hospital.RESULTS System could come down with the hospital infection case which every hospital department could find to check,put in order,report,count,analyze,have a look around,inquire about,feedback,form the monitoring chart with excellent pictures and texts,and make the better prognosis of the nosocomial infection outbreak.CONCLUSIONS Beijing nosocomial infection surveillance and management system is a medical quality control system of a hospital.This software could afford scientific and standard data for the health care institution and administration to realize the primary information of nosocomial infection and make decisions.