Objective To describe an appreciate operation method in the treatment of deformi-ties secondary to gluteal muscles and fascia contracture. Methods 25 cases of serious secondary de-formity of gluteal muscles and fascia contracture were treated by Z-plasty. The contracted fascia and scar were loosed and the skin around the wound was rearranged. Results The following-up time was from 6 months to 3 years with an average time of 1.6 years. All cases rehabilitated to normal or nearly normal in gait. Aesthetic results were also satisfactory. No recurrence was observed. Conclusion Re-arranging the contracted fascia with Z-plasty can extend the fascia and improve the movement of the hip joint. Besides, Z-plasty treatment of skin around the scar is benefit for the aesthetic result of the deformities, Z-plasty of contracted fascia and skin is an appreciate operation method in the treatment of deformities secondary to gluteal muscles and fascia contracture.

Objective To investigate the nursing of cancerous aching in patients during whole body hyperthermia. Methods Seventy patients with malignant tumors were carefully concerned before and after receiving whole body hyperthermia and their responses were recorded. Results The remission rate of aching was 88.55%, and the common side effects were burning of skin, bedsore, and nausea or vomiting. Conclusion The whole body hyperthermia therapy can relieve the cancerous pain, and good nursing can improve the efficacy.

Objective To compare the clinical effects of extensive or limited arthroscopic debridement in varying degrees of knees osteo-arthritis. Methods 32 cases with knees osteoarthritis who underwent extensive debridement under arthroscopy were selected as the observa-tion group, and 30 cases with knees osteoarthritis who underwent limited debridement were selected as the control group. The excellent rate of joint function, Lysholm and VAS scores were compared between the two groups. Results The excellent rate of joint function were 90. 0%and 91. 4% in observation group and control group respectively, without significant difference (P>0. 05). Lysholm scores of patients with grade Ⅱ osteoarthritis was much higher in observation group than that in control group after operation (P<0. 05). There was no significant difference in Lysholm scores between gradeⅠand gradeⅢosteoarthritis (P>0. 05). No statistically significant difference of VAS scores on 1 year after operation were found (P>0. 05). Conclusion Extensive debridement and limited debridement under arthroscopy have similar effects for knees osteoarthritis. Extensive arthroscopic debridement is an ideal treatment method for Ⅱ grade of knees osteoarthritis.

Objective To evaluate the safety and rationality of total/near total bilateral thyroidectomy(TBT) for patients with bilateral multinodular goiter(BMG). Methods From January 2003 to December 2006,311 BMG cases were preoperatively divided into two groups, 130 cases in group A underwent TBT, and 181 cases in group B were treated with subtotal/partial bilateral thyroidectomy. Results There were 6 and 2 eases in group A and group B respectively diagnosed by intraoperative frozen biopsy as BMG, but identified as papillary carcinoma by final pathology. Hence the 6 cases in group A avoided reoporation, while the 2 cases in group B underwent a resection of the remnant gland. Transient hoarseness developed in 3 (2.42%, 3/124) and 3 (1.68%, 3/179) eases in group A and group B respectively (P =0.48). Transient hypocalcemia developed in 11 (8.87% ,11/124) and 9(5.03% ,9/179) cases in group A and group B respectively(P =0.16). There was no postoperative goiter recurrence in group A, but recurrence developed in 12 cases (6.70%,12/179) in group B(P=0.02). Conclusions Total bilateral thyroidectomy is safe and rational for the management of bilateral thyroid goiter.

Objective To explore the medical care and evacuation equipment at sea in China.Methods The present situation of the medical care and evacuation equipment at sea in China was discussed from the aspects of equipment system,medical service support,mechanism for utilization,management and maintenance as well as informatization.The problems were analyzed in equipment system,support ability,equipment integration and update as well as equipment performances.Results Some measures were put forward from the aspects of equipment system,support ability,equipment integration and update as well as equipment performances.Conclusion The development of medical care and evacuation equipment at sea has to take considerations on medical service requirements at sea,integrated civilian and military uses,personnel,innovation and etc.

Objective: To investigate the prevalence of postoperative delirium(PD)and its risk factors in patients aged 80 and over with hip fracture treated with total hip arthroplasty(THA). Methods: Clinical history and perioperative data of patients aged 80 years and over with hip fractures who underwent THA in our hospital from Sep.2017 to Mar.2019 were analyzed.Patients were divided into delirium group and non-delirium group.The prevalence of postoperative delirium of THA and its risk factors were analyzed by multiple Logistic regression. Results: A total of 90 patients were eligible for inclusion for this study.Of them, 27 patients(30.0%)were diagnosed as PD and 63(70.0%)did not experience PD.Multivariate stepwise Logistic regression analysis showed that a history of stroke(OR=17.702, 95%CI: 1.514-207.034, P=0.022), preoperative lower serum albumin(OR=1.524, 95%CI: 1.132-2.051, P=0.005), Mini-Nutritional Assessment short-form score(MNA-SF)(OR=1.481, 95%CI: 1.045-2.099, P=0.027)were independent risk factors for PD. Conclusions The prevalence of postoperative delirium of THA is higher in patients aged 80 years and over with hip fractures.Prevention and correction of risk factors, such as malnutrition, may help prevent the postoperative delirium.

Objective To analyze the expression of MIAT in colorectal cancer and explore its molecular mechanism.Methods The expression of MIAT mRNA in colorectal cancer tissues and paracancerous tissues,colorectal cancer cell lines and human normal colorectal mucosa cells was detected by RT-qPCR.HCT-116 cells were transfected with MIAT overexpression vector and infected with knockdown lentivirus,cell proliferation and cell cycle were detected,Western blot was used to analyze the β3-catenin protein levels,luciferase assay was used to detect β-catenin promoter transcription level,C-myc,CCND1,CD44 and Oct3/4 mRNA levels was measured by RT-qPCR.Results The expression of MIAT in colorectal cancer tissues was significantly higher than that in adjacent tissues (t =4.093,P ＜ 0.05).Overexpression of MIAT could promote the proliferation of HCT-116 cells,decrease the rate of G0/G1 phase,activate Wnt/β-catenin pathway and increase its downstream target gene mRNA expression levels (all P ＜ 0.05).Knockdown MIAT shows the inhibition effect.Conclusions MIAT is a tumor-promoting gene of colorectal cancer and may play a role in tumor promotion by activating Wnt/β3-catenin pathway.

Objective To evaluate the efficacy and safety of perioperative anticoagulation and antiplatelet therapy of carotid endoarterectomy (CEA). Methods A retrospective study on 110 cases (122 CEAs) of carotid stenosis between Jan 2004 and Dec 2008 was undertaken. 122 cases were divided into anticoagulation group and antiplatelet group according to the perioperative medical treatment. Postoperative results of stroke/death and wound hemotoma were compared between the two groups and statistically analyzed. Results 45 CEAs were given perioperative combination of anticoagulation and antiplatelet treatment. This comprised the anticoagulation group. The antiplatelet group consisted of the other 77 CEAs which were treated with antiplatelet solely. Perioperative stroke/death rates were equivalent (2.2% anticoagulation vs. 2.6% antiplatelet, P =0.897). Wound hemotoma rates were found with statistical significant difference between the two groups (13.3% anticoagulation group vs. 1.3% antiplatelet group, P = 0. 006 ). Conclusion Our results suggest that perioperative antiplatelet therapy in perioperative carotid endoarterectomy does not increase perioperative stroke/death risk, while perioperative anticoagulation increases the risk of wound hematoma.

Objective To compare the effectiveness of controlling blood loss in the treatment of complex acetabular fracture between temporary occlusion of abdominal aorta by interventional balloon (TOAAIB),temporary occlusion of common iliac artery by interventional balloon (TOCAIIB) and internal iliac artery ligation (IIAL).Methods Included for this study were 113 complex acetabular fractures which had been treated at Department of Orthopaedic Trauma,Shaoguang Hospital Affiliated to Southern Medical University from January 2000 through January 2017.There were 68 males and 45 females,aged from 23 to 61 years (average,42.3 years).According to the Letournel classification,all of them belonged to complex fractures,including 10 T-type,24 double-column,16 posterior column & posterior wall,46 transverse & posterior wall and 15 anterior & posterior half-transverse ones.They were all treated by open reduction and internal fixation but differed in surgical hemostasis techniques:TOAAIB was used in 37cases,TOCAIIB in 31 and IIAL in 45.Fracture reduction was evaluated by Matta criteria.Intraoperative bleeding and postoperative wound drainage,fracture union and complications related to interventions were recorded.Hip function was evaluated by Modified d'Aubigne & Postal clinical grading system after fracture healing.Results The 3 groups (TOAAIB,TOCAIIB and IIAL) were comparable because there were no significant differences in gender,age,time from injury to surgery,Letournel classification or surgical approaches between the patients in the 3 groups (P ＞ 0.05).Anatomical reduction was achieved in 91.15％ of the patients (103/113) and satisfactory reduction in 8.85％ (10/113).Intraoperative hemorrhage was 1,631.5 ±675.5 mL in the HAL group,892.6 ±217.7 mL in the TOCAIIB group and 648.0 ± 170.2 mL in the TOAAIB group,showing significant differences between the 3 groups (P ＜ 0.05).One case of femoral artery thrombosis occurred in the TOAAIB group at the end of operation but was cured by symptomatic treatment of anticoagulation.There were no interventional complications in the other 2 groups.There were no significant differences between the 3 groups in postoperative wound drainage,fracture union time,hip function score or complications (P ＞ 0.05).Conclusions In controlling intraoperative bleeding in the surgery for complex acetabular fracture,TOAAIB may be the best,followed by TOCAIIB,and IIAL may be the worst.However,choice of a proper surgical hemostasis technique should also depend on the specific intraoperative condition of a specific patient.

Objective To study the effect of CBT resection on blood pressure in essential hypertensive subjects.Methods Clinical data of 24 essential hypertensive patients (BP ＞ 140/90 mmHg or was using anti-hypertensive drugs) with CBT resection from May 2005 to March 2016 was analyzed,retrospectively.The heart rate,blood pressure were recorded continuously during the peri-operative and follow-up period.All of the patients were followed-up for at least 1 year.Results The systolic blood pressure(SBP) and pulse pressure (PP) decreased 1-3 months after the operation,and the difference was significant (P ＜ 0.001),while the diastolic blood pressure (DBP) and heart rate (HR) did not change significantly (P ＞ 0.05).Postoperative patients used less amount of antihypertensive drugs,but the difference was statistically not significant (P ＞ 0.05).Conclusions Unilateral CBT resection is associated with short-term to intermediate-term lowering of BP in hypertensive patients (P ＞ 0.05).