Adult ; Computer Terminals ; Humans ; Male ; Paper ; Reading ; Students, Medical ; Workload

30 kg/m2 served as obesity group.Using Gross formula,the true total blood loss was calculated depending on the height,body mass and pre-and post-operative Hct,and hidden blood loss was gotten by subtracting the visible blood loss from total loss.③The correlation between visible and hidden blood loss was observed.RESULTS:All 41 patients undergoing THA and 37 TKA were involved in the result analysis.①Following THA,the mean total loss was 1 520 mL and the hidden blood loss 482 mL(32%).Following TKA,the mean total loss was 1 508 mL and the hidden blood loss was 776 mL(52%).The hidden blood loss between THA and TKA was significantly different(P 0.05).CONCLUSION:①The hidden blood loss in TKA is far higher than THA.It is very important to supplement the blood volume during TKA for the insufficiency to regain general circulation although using blood re-infusion.②It may improve clinical evaluation capabilities to estimate hidden blood loss and thus result in better patient care after joint arthroplasty.

The notational DSA was first proposed for the application as a managing tool of neuronradiology in the early 70's of 20th centery.Later on,three dimensional image reconstruction(3D DSA) was aquired along with the progressing development of technique and equipment devices.As a rather practical instrument,it has been utilized successfully in the diagnosis and management of head and neck vascular disorders,and abdominal parenchymal diseases during recent years.We comprehensively intoduce the application of rotational DSA for the diagnosis and management in hepatic diseases.

BACKGROUND:Tissue-engineered bone in the treatment of large bone defects has obvious advantages especial y when the autologous ilium transplantation is limited, which can effectively fil bone defects.
OBJECTIVE:To investigate the rationality of intramedul ary nailing support and tissue-engineered bone fil ing in the treatment of fibrous dysplasia of the proximal femur and the biocompatibility of the tissue-engineered bone.
METHODS:Seven patients with fibrous dysplasia of the proximal femur were subjected to intramedul ary nailing support and tissue-engineered bone fil ing.
RESULTS AND CONCLUSION:Al of the seven patients underwent more than 8 months of fol ow-up, no rejection reaction and other complications occurred. After 4-6 weeks of fixation, al the seven patients removed hip spica braces, with a good hip mobility. After 10-12 weeks, X-ray review showed no pathological fracture, internal fixation loosening and narrow neck stem angle. Using the Harris hip score evaluation of the hip function, the affected side of the seven patients was optimized. After 16-18 weeks, X-ray films reviewed good creeping substitution in the affected area treated with the intramedul ary nailing support and bone graft. After 24-26 weeks, new bone appeared within the scope of lesions. After 1.0-1.5 years, bone creeping substitution was basical y completed in the intertrochanteric region, and original lesions were invisible on X-ray films. These findings confirmed that intramedul ary nailing support and tissue-engineered bone fil ing for treating fibrous dysplasia of the proximal femur has good effectiveness, exhibiting stable internal fixation and avoiding resection of autogenous iliac bone. Tissue-engineered bone has a good biocompatibility in the medium-term fol ow-up, with good hip function activities.

Objective:To analyze ultrasonic and clinical manifestation of noncompaction of the ventricular myocardi‐um (NVM) in order to guide clinical early diagnosis and treatment .Methods :Echocardiographic manifestations of 36 NVM patients were observed .Combined with electrocardiogram (ECG) ,cardiac MRI and coronary angiography (CAG) etc .,clinical manifestations of NVM were comprehensively analyzed .Results:Multiple coarse trabecular muscles and deep crypts among them were founded in heart chamber in all cases .Color Doppler showed that blood flow inside the crypts communicated with blood flow in heart chamber ,there were 33 cases (91.6% ) of left ventri‐cle type and three cases (8.4% ) of right ventricle type .Different types of abnormal ECG existed in all cases and at‐rial fibrillation occupied the largest proportion (50% ,18/36) .Some MRI results were accorded with those of ultra‐sound .In most cases ,CAG didn′t show coronary stenosis .Conclusion : Echocardiography is most convenient and effective examination ,which can provide important basis for diagnosis and treatment of noncompaction of ventricular myocardium .

Objective To investigate the diagnosis of a case with 7p15.3p22.1 microdeletion by applying array-based comparative genomic hybridization (array-CGH) and to analyze the relationship between the clinical manifestations and 7p15.3p22.1 microdeletion. Method Array-CGH technique was used to detect genomic copy number variations (CNVs) in an infant with normal karyotype after conventional chromosomal karyotyping. Results Array-CGH detected 7p15.3p22.1 deletion (chr7: 6777262-23981753), which was confirmed as pathogenic CNV after comparative analysis with database. Conclusion Array-CGH could serve as a useful complement for G-banding to be used in the clinical cytogenetic diagnosis.

Objective To obtain recombinant human Smith D1 (Sm D1) antigen and establish detecting assay.Methods Human Smith D1 antigen was synthesized by PCR using human Leukemic cDNA. The prokaryotic expression vector pGEX-ST-Sm D1 was constructed and transformed into E.coli.BL21 cell.Protein expressed under the induction of IPTG.We established DIGFA for detecting anti-Sm D1 antibodies with purified Sm D1 antigens.Results Sequence and restriction analysis revealed Sm D1 gene was cloned in frame into pGEX-5T,SDS-PAGE profile showed a clear protein band with a relative molecular weight of 39 000 and western blotting indicated that the expressed product specifically reacted to polyclonal anti-human Sm D1 genes.There was no significant difference between DIGFA and IB.The agreement between DIGFA and IB was 91.7% as calculated by Kappa statistical method.The sensitivity and specificity of DIGFA were 100% and 83.3% repectively.Conclusions Human Sm D1 gene is successfully cloned、 expressed and purification.The DIGFA,using purified Sm D1 antigens,is as good as IB,rather simpler, more rapid and reliable assay.

Objective:To investigate the clinicopathological characteristics and influencing factors of kidney prognosis in primary IgA nephropathy (IgAN) patients.Methods:The data of primary IgAN patients diagnosed with renal biopsy in the First Affiliated Hospital of Anhui Medical University from January 2015 to September 2019 were retrospective analyzed. According to the level of baseline estimated glomerular filtration rate (eGFR) when performing renal biopsy, the patients were divided into group A[eGFR≥90 ml·min -1·(1.73 m 2) -1], group B[eGFR 61-89 ml·min -1·(1.73 m 2) -1] and group C[eGFR≤60 ml·min -1·(1.73 m 2) -1]. The clinical and pathological data were collected and compared among the three groups. Kaplan-Meier method was conducted for renal results, whereas the Cox proportional-hazards regression model was exploited to analyze the influencing factors of kidney prognosis in IgAN patients. Results:A total of 742 patients were included in the study, including 394 cases (53.1%) in group A, 203 cases (27.4%) in group B, and 145 cases (19.5%) in group C. There were 325 males (43.8%) and 417 females (56.2%). The median duration of renal biopsy was 6 (1, 24) months, and the median age was 36 years old (18-68 years old). As the baseline level of renal function decreased, the proportion of patients with nephrotic syndrome, hypertension, anemia and hyperuricemia and the levels of 24 h urinary protein, serum triglyceride and total cholesterol increased significantly (all P<0.05), while the proportion of gross hematuria episodes and the ratio of serum albumin to globulin significantly decreased (all P<0.05). For the aspect of pathological manifestations, the proportions of cell proliferation in capillaries (E1), segmental sclerosis or adhesion (S1), renal tubular atrophy or interstitial fibrosis (T1/2), globular sclerosis, renal arteriole wall thickening and vitreous degeneration, Lee's grade Ⅳ and Ⅴ increased with the decrease of baseline renal function (all P<0.05). Kaplan-Meier analysis showed that the cumulative renal survival rate decreased with the decline of baseline renal function (Log-rank χ2=88.510, P<0.001). As a result of multivariate Cox regression analysis, nephrotic syndrome ( HR=2.399, 95% CI 1.054-5.459, P=0.037), hypertension ( HR=1.806, 95% CI 1.071-3.048, P=0.027), low baseline eGFR (taking group A as the reference, group B: HR=2.383, 95% CI 1.053-5.392, P=0.037; group C: HR=6.878, 95% CI 3.074-15.393, P<0.001), IgG deposition ( HR=2.224, 95% CI 1.384-3.574, P=0.001) and globular sclerosis ( HR=2.075, 95% CI 1.230-3.501, P=0.006) were the independent influencing factors for renal progression in primary IgAN patients. Conclusions:The level of baseline renal function in primary IgAN patients can be used to predict the extent of clinic-pathological damage. Nephrotic syndrome, hypertension, low baseline eGFR, IgG deposition and globular sclerosis are the independent influencing factors for renal progression in primary IgAN patients.

OBJECTIVE:To observe the efficacy and safety of carboprost and Foley catheter for the expand cervix before hys-teroscopic electric resection. METHODS:80 patients with hysteroscopic operation were randomly divided into research group and control group. Research group was placed inside the vagina carboprost 1 mg 30 minutes before operation;control group was placed inside the Foley catheter 12 hour before operation. The relaxation degree of the cervix,average operative time,preoperative pain, postoperative morbidity and incidence of adverse reactions in 2 groups were observed. RESULTS:There were no significant differ-ences in the relaxation degree of the cervix,postoperative morbidity and incidence of adverse reactions between 2 groups(P>0.05). The average operative time and preoperative pain in research group were significantly better than control group,the differ-ence was statistically significant(P<0.05). CONCLUSIONS:Carboprost and Foley catheter have good efficacy and safety for ex-pand cervix before hysteroscopic electric resection,however,carboprost is better than Foley catheter in terms of average operative time and preoperative pain.