BACKGROUND:Many patients underwent aspirin anticoagulation in preventing cardiovascular disease before hip and knee replacement. No report addressed the effect of aspirin on blood loss during perioperative stage in patients receiving hip and knee replacement. OBJECTIVE:To observe the effect of perioperative continuous low-dose aspirin anticoagulation application on total hip arthroplasty or total knee arthroplasty. METHODS: A total of 40 patients with primary total hip arthroplasty or total knee arthroplasty were enroled in the Department of Orthopedics, Tianjin First Center Hospital from December 2012 to August 2013. According to anticoagulation scheme, they were divided into two groups (n=20). In the observation group, 100 mg/d aspirin anticoagulation was continuously used before replacement for a long period, and the medicine was not withdrawn except the day of replacement. In the control group, aspirin anticoagulation was not used, and their ages were similar to the observation group. The operation was conducted by the same physician in the observation and control groups. 10 patients received total hip arthroplasty and 10 patients received total knee arthroplasty in both groups. Bleeding was stopped actively during replacement. After replacement, pressurized ice compress was used to reduce bleeding. At 48 hours after replacement, wound drainage, perioperative hemoglobin and the incidence of complications were recorded. Joint function recovery was observed at 3 months of folow-up. RESULTS AND CONCLUSION:Hemoglobin levels before and after operation, postoperative blood drainage at 48 hours, perioperative hemoglobin changes, the incidence of complication, and joint function score at 3-month folow-up did not show significant difference between both groups. These findings indicate that it is safe to use some measures for reducing blood loss and continue low-dose aspirin in the perioperative period. The use of aspirin did not impact blood loss.

Mixed reality technology can achieve a 3D reconstruction of the patient's imaging data and organically combine the real scene. This allows to simulate a real medical operation in clinical teaching. Combined with large data analysis, mixed reality technology allows to build situational awareness data models, thus providing data support for teaching interaction and disease simulations. In the present work, the application of mixed reality technology and situational awareness in clinical teaching of cardiac macrovascular surgery is explored innovatively. These technologies open a new avenue for teaching, solving the issue that stymies traditional teaching approaches and improving the teaching efficiency. It is thus important to explore and promote the applications of this innovative teaching methodology particularly in clinical teaching.

Electroencephalogram (EEG) classification for brain-computer interface (BCI) is a new way of realizing human-computer interreaction. In this paper the application of semi-supervised sparse representation classifier algorithms based on help training to EEG classification for BCI is reported. Firstly, the correlation information of the unlabeled data is obtained by sparse representation classifier and some data with high correlation selected. Secondly, the boundary information of the selected data is produced by discriminative classifier, which is the Fisher linear classifier. The final unlabeled data with high confidence are selected by a criterion containing the information of distance and direction. We applied this novel method to the three benchmark datasets, which were BCI I, BCI II_IV and USPS. The classification rate were 97%, 82% and 84.7%, respectively. Moreover the fastest arithmetic rate was just about 0. 2 s. The classification rate and efficiency results of the novel method are both better than those of S3VM and SVM, proving that the proposed method is effective.
Algorithms ; Brain-Computer Interfaces ; Electroencephalography ; classification ; Humans

OBJECTIVE: To investigate the diagnosis of frontal, ethmoid sinus cyst with eye symptoms as initial amount,and the curative effect of nasal endoscopic operation. METHOD: To retrospectively analyze clinical data of sixteen patients with frontal, ethmoid sinus cyst from February 2006 to March 2008. RESULT: Diagnostic accordance rate of paranasal sinus MRI and CT examination In 16 patients is 100%. Fourteen patients' ocular symptoms disappeared after nasal endoscope operation treatment, two of them improved. None of them recurrened after the fol low-up 3-6 years up to now, all the patients had satisfactory curative effect. CONCLUSION Paranasal sinuses and or bital cavity have close relationship , patients with sinus lesions always firstly visit Ophthalmology doctor. The results of MRI and CT examination are of great value for diagnosis. Patients with frontal, ethmoid sinus cyst with eye symptoms as initial amount should be early diagnosed. The treatment of nasal endoscope operation is safe, effective and is worth of firstly chosen.
Cysts ; diagnosis ; surgery ; Endoscopy ; methods ; Ethmoid Bone ; Ethmoid Sinus ; Female ; Frontal Sinus ; Humans ; Magnetic Resonance Imaging ; Male ; Nasal Surgical Procedures ; Paranasal Sinus Diseases ; diagnosis ; surgery ; Retrospective Studies

Objective To understand genetic distribution, drug resistance, molecular typing and the epidemiological relativeness between strains of the Shigella boydii virulence. Methods Nine Shigella boydii strains were isolated form stool samples of patients with diarrhea from the Enteric Disease Clinic of the Second Hospital of Tianjin Medical University in June-October 2015. The strains were identified by biochemical test and serum agglutination test. Antibiotics susceptibility test was carried out using the Kirby-Bauer method. Polymerase chain reaction was used for detecting virulence genes. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) technique were used to determine the epidemiological relationship between nine Shigella boydii strains. Results There were three subtypes in nine isolated Shigella boydii samples, including one, three and five isolates inⅠ,Ⅱ,Ⅳsubtypes respectively. All of the 9 isolates were multi-drug resistant. The resistant rate of these strains for ampicillin was 100%(9/9), and then the resistant rates of these strains for ceftazidime, streptomycin, gentamicin, trimethoprim/sulfamethoxazole, cefotaxime, ceftriaxone, norfloxacin and levofloxacin were 1/9, 4/9, 4/9, 4/9, 5/9, 5/9, 6/9, 6/9 and 6/9, respectively. All of these strains were sensitive to amikacin, cefperazone-sulbactam and imipenem. The ipaH was carried by all the testing strains, and none of the strains carried the sen, set1A, set1B, ial, virA, icsA and SigA. The detective rates of pic, sepA and sat were 4/9, 5/9 and 7/9 strains, respectively. Nine shigella boydii strains were divided into 8 PFGE types. The similarity between the spectrums of PFGE was 63.21%-100%. Multilocus sequence typing showed that six isolates were belonged to ST648, two isolates were ST131 and one isolate was ST10. Conclusion Nine isolates of Shigella boydii (divided into three subtyping) isolated from our hospital are multi-drug resistant and they have distant relationships, belonging to the dissemination of case.

Because of the specificity of infectious diseases , the the medical ethics education and concepts need to be paid more attention to .During the clinical teaching of infectious diseases , pay attention to teachers′medical ethics accomplishment level of ascension , teaching teachers should play the role of shape model , encourage interac-tion, eliminate the fear and discrimination interns and strengthen medical ethics consciousness and the combination of legal concepts , promote the medical students medical ethics consciousness of the form .

Due to its advantages of low wear, high stability and flexibility, the new generation metal-on-metal hip prosthesis is favored by many patients with hip diseases, especially young patients. However, in recent years, several studies have indicated that adverse reactions to metal debris (ARMD) caused the formation of inflammatory pseudotumor, which ultimately led to a higher revision rate after metal-on-metal hip arthroplasty. This aroused the widespread concern from doctors and patients. Moreover, revision surgery for metal-on-metal hip arthroplasty in the setting of inflammatory pseudotumor is faced with a great risk of failure because of the large defects of bone and surrounding soft tissue and difficulty in removing the original prosthesis and the fixing of the modified prosthesis. Therefore, the use of such products is restricted with caution in their choice. We summarized the recent developments in the research in the risk factors, diagnosis and treatment of inflammatory pseudotumor after metal-on-metal hip arthroplasty. The risk factors for the formation of inflammatory pseudotumor around the hip prosthesis mainly include the increase of metal ion concentration, the position of prosthesis implantation and the patient's own factors. The diagnosis mainly depends on physical examination, imaging examination, laboratory examination, arthroscopy and histological examination. The treatment strategies for clinical symptomatic and asymptomatic patients are also varies. Through the detailed analysis, evaluation and summary of the above contents, we may provide guidance for the selection of hip prosthesis, and lay the foundation for further exploration of the mechanism of inflammatory pseudotumor caused by ARMD.

Objective To observe and study the late effects of intrauterine exposure to irradiation.Methods A 16-year-old girl,borne by a woman exposed to 60Co irradiation during the Xinzhou radiation accident 16 years ago underwent inquiry,general medical examination.Conventional chromosome aberration analysis and fluorescence in situ hybridization (FISH) were used to examine non-stability and stability chromosome aberrations,and China revised Wechsler Intelligence Scale for Children (C_WISC)was used to detect IQ level.Results Inquiry revealed no history of carcinoma and no family history of hereditary diseases.The girl often caught cold when she was a child,but she hadn' t any other diseases.Menarche occurred when she was 12 years old,and she had not suffered from dysmenorrhea.Her development of body frame constitution was normal.She could not carry out addition and subtraction,but she could make simple verbal communication,writing and even reciting text.The results of the routine lab examination were within the normal range.Unstable chromosome aberrations were not shown,and the chromosome translocation rate was 2.3%.The dose that induced the chromosome injury was deduced as 0.81 Gy.The biological dose of the radiation that she was exposed to was inferred to be 1.85 Gy when she was in ther mother's uterus.Ultrasonic sound showed nodular goiter and no malignant change.China's revised Wechsler Intelligence Scale for Children (C_WISC) test results showed that speech,operation and full-scale IQ was 51,50,and 46 respectively.The total intelligence was better than 0.01% ,and worse than 99.90% of the population.Conclusions Exposure in utero does not affect the body frame constitution development after birth of the fetus,but mental retardation is clear.No evidence of any tumor can be found for the children exposed to radiation before their birth.

Objective To investigate the late effect of radiation on child-bearing women,through observing "Fang",a 19-week-pregnant woman at age of 23,who was exposed to 60Co radiation in Shanxi Xinzhou radiation accident in November,1992 and diagnosed as moderate bone marrow type acute radiation sickness and recovered after 16 year of follow-up treatment.Methods Clinical data including medical history,physical examination,laboratory data,imaging findings and consulting relevant departments were reviewed.Results The followed-up woman "Fang" often felt weak and caught cold after recovery.When she was 32 years old (9 years after radiation),her hair turned grey,but without hair loss.Her menstrual quantity was lessened since 31 years old (8 years after radiation).She was remarried and pregnant twice in the same year.At the first time she underwent artificial abortion and the second child suffered from intrauterine death after 6 months of pregnancy.The physical examination found bilateral degree Ⅰ thyroid enlargement and sparse armpit hair.The laboratory test showed the increased levels of triiodothyronine,thyroxine and anti-thyroid peroxidase antibody (TMAb) and the decreased thyroid stimulating hormone (TSH).Unstable chromosome aberrations were totally lost and stable aberrations in chromosomes were detected by fluorescence in situ hybridization (FISH).The dose estimated with the residue chromosome aberration was 0.76 Gy.Other laboratory results were normal.Ultrasonic test showed diffuse lesion in bilateral thyroid and multiple cystic nodules in right lobe of thyroid,which was considered to be nodular goiter.The examination of bone mineral density (BMD) showed osteoporosis from the second to the fourth lumber vertebra.There were no diseases associated with radiation based on the consultation from related departments.Conclusions Intrauterine death after 6 months of pregnancy might be associated with the previous exposure.There is no evidence of malignant tumor,but non-cancerous diseases are obvious.

OBJECTIVE: To explore the expression of Smac(second mitochondria-derived activator of caspase)and survivin on the growth, development, recurrence and carcinogenesis of the sinonasal inverted papilloma(NIP). METHOD: Immunohistochemical method was used to detective the expression of Smac and survivin in 10 cases of (nasal cavity mucosae, NM), 45 cases of NIP. The NIP group including 25 cases of NIP without dysplasia, 11 cases of NIP with dysplasia, and 9 cases of NIP with malignant transformation to squamous cell carcinoma(SCC). RESULT: The intensity of the positive expression of Smac in NIP was lower than NM, the intensity of the positive expression decreased with the decreasing degree of histological differentiation. There was significantly difference between NIP without dysplasia and SCC. The expression of survivin was negative in the control group, the expression intensity of NIP was enhanced. The degree of histological differentiation was lower, the intensity of the positive expression was higher. The expression between NIP without dysplasia and SCC had significantly differences. Smac negatively correlated with survivin(rs = -0.403, P<0.01). CONCLUSION Smac and survivin were associated with the growth and carcinogenesis of NIP.
Adult ; Aged ; Female ; Humans ; Inhibitor of Apoptosis Proteins ; metabolism ; Intracellular Signaling Peptides and Proteins ; metabolism ; Male ; Middle Aged ; Mitochondrial Proteins ; metabolism ; Nasal Mucosa ; metabolism ; pathology ; Nose Neoplasms ; metabolism ; pathology ; Papilloma, Inverted ; metabolism ; pathology ; Survivin