Objective To analyze risk factors for perioperative blood transfusion in elderly patients undergoing uni-lateral primary total hip arthroplasty and develop a prediction model.Methods The study retrospectively collected 467 elderly patients receiving unilateral primary total hip arthroplasty between January 2013 and October 2021 at Peking Union Medical College Hospital.The 70%of the data were used as the training set and the 30%of the data were used as the testing set.Patients were divided into the transfusion and no-transfusion groups based on the presence or absence of perioperative blood transfusion.Univariate analysis and multivariable logistic regression were conducted to analyze patient demographic characteristics,surgical information,and preoperative laboratory tests for identifying risk factors.Clinical experience was combined to establish a prediction model and draw the nomogram.The receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the model in the tes-ting set.Results A total of 91 patients(19.5%)received perioperative blood transfusion.Multivariable logistic re-gression suggested the history of coronary artery disease,prolonged operation time,and lower preoperative hemoglo-bin were risk factors for perioperative blood transfusion(P＜0.05).The prediction model was constructed based on the results of statistical analysis and clinical experience,including the history of coronary artery disease,operation time,preoperative hemoglobin,age,and American Society of Anesthesiologists(ASA)physical status＞Ⅱ.The area under the receiver operating characteristic curve(AUC)of the model was 0.809.Conclusions The prediction model for perioperative blood transfusion in elderly patients undergoing unilateral total hip arthroplasty had a good performance and could assist in clinical practice.

Objective:To investigate the clinical manifestation, genetic characteristics, treatment and prognosis of Crouzon-like syndrome.Methods:Clinical data of one case of Crouzon-like syndrome diagnosed in Children′s Hospital Affiliated to Zhengzhou University in May 2019 were collected, including clinical test, treatment plan, follow-up outcomes. The clinical characteristics and the mutation characteristics of IL11RA-related Crouzon-like syndrome were analyzed combined with the literature.Results:The male proband, five years and four months old, was admitted with the main clinical manifestations including headache, vomiting, exophthalmos, ocular hypertelorism, nasal root flat and scaphocephaly. CT showed that the cerebellar tonsil moved down slightly, the occipital magnum was full, the bilateral cranial plates were locally thinner, the bilateral cranial diameters were increased, and the cranial seams were closed. Magnetic resonance imaging showed ChiariⅠmalformation. The mutation c.40_63del and splice site mutation c.811-2A>G of the patient′s IL11RA gene were screened by whole exome sequencing. Sanger sequencing showed that the mutations are compound heterozygous and both are first reported. The mutation c.811-2A>G was derived from the patient′s mother, and the other one is de novo.Conclusions:The main clinical manifestations of Crouzon-like syndrome are craniosynostosis and midface hypoplasia and ocular deformity. The study identified two novel mutations in the Crouzon-like syndrome related IL11RA gene. Genetic sequencing is helpful for accurate diagnosis and timely surgical treatment.