Objective To analyze the risk factors of pulmonary hypertension in patients with systemic lupus erythematosus (SLE-PH).Methods Echo data of 598 SLE patients were collected,clinical characteristics of 107 suspected SLE-PH (PASP ≥40 mmHg,estimated by Echo) and 64 suspected moderate to severe PH (PASP ≥50 mmHg) were retrospectively analyzed.T-test,x2-test and Logisticregression were used for statistical analysis.Results Out of 598 patients 70.7％(423 patients) had abnormal Echo findings,and pericardial effusion in 45.5％(272 cases),valvular insufficiency in 31.3％(187 cases),suspected PH in 17.9％(107 cases),left ventricular enlargement in 5.9％(35 cases),left ventricular hypertrophy in 4.3％(26cases).In addition 1.7％ had mitral valve prolapse,1.5％ had mitral valve vegetation,and right ventricular enlargement in 6.5％(39 cases),LVEF＜50％ in 6.0％(36 cases),right ventricular systolic dysfunction in 2.2％(13 cases).Logistic regression analysis showed Raynaud's phenomenon (OR=3.205,95％CI:1.911-5.375,P=0.000),thrombocytopenia (OR=1.680,95％CI:1.049-2.689,P=0.031),hyperuricemia (OR=3.643,95％CI:2.154-6.164,P=0.000),and anti-U1RNP antibody positivity (OR=1.777,95％CI:1.099-2.874,P=0.019)were independent risk factors for suspected SLE-PH,fever (OR=0.576,P=0.029)and rash (OR=0.558,P=0.017) were independent protective factors for suspected SLE-PH.SLE duration (OR=1.145,95％CI:1.016-1.290,P=0.026) and Raynaud's phenomenon (OR=3.371,95％CI:1.126-10.086,P=0.030)were independent risk factors for suspected moderate to severe PH,nephritic syndrome (OR=0.042,P=0.009) was the in dependent protective factor for suspected moderate to severe PH.Conclusion Cardiac involvement is common in SLE patients.Screening for PH should be considered in SLE patients with thrombocytopenia,hyperuricemia,anti-U1RNP antibody positivity,particularly with Raynaud's phenomenon.

BACKGROUND:Resection of femoral neck in the conventional total hip replacement greatly influences the equilibrium of forces jn the proximal fetour and causes disequilibrium of bone reconstruction,easily resulting in bone absorption,prosthesis loosening and dislocation.OBJECTIVE:To investigate the biocompatibility between materials and host in the total hip replacement with femoral neck preserved.DESIGN,TIME AND SETTING:A retrospective case analysis was performed in the Department of Orthopedics,the 180 Hospital of Chinese PLA between September 2000 and December 2006.PARTICIPANTS:Twenty-five patients.10 males,15 females,aged 47 years old(range 31-56 years old)were recruited for this study.Twelve patients suffered from femoral head necrosis-caused hip joint disease and osteoarthrosis(bilaterally affected in 5 patients),eight femoral head necrosis(femoral head necrosis subsequent to femoral neck fracture healing in 2 patients),three acetabular dysplasia necrosis of femoral head,and two infra-head femoral neck fracture nonunion.The course of disease averaged 6 years old ranging from 2-10 years.METHODS:Modified hip ioint posterior approach was used to expose the hip joint.Femoral head was resected from the femoral head-neck iuncture.Cartilago acetabularis was stripped and then artificial acetabulum was installed.Femoral proximal medullary cavity was expanded.Artificial femoral head was installed.Finally,all artificial joints were reduced.MAIN OUTCOME MEASURES:(1)Biocompatibility between prosthesis and host.(2)Function recovery of hip joint.RESULTS:All wounds were primarily healed.Patients were followed up for 0.5-6 years on average.Follow-up results demonstrated good hip joint motion and normal walking gait.X-ray showed well-positioned artificial hip joint,absence of prosthesis loosening and dislocation,as well as good femoral neck sclerotin.CONCLUSl0N:The preservation of femoral neck in total hip replacement is fit to the physiological compliance of proximal femar and prevents osteoporosis-induced prosthesis loosening and dislocation in the proximal femur.

Objective:To investigate the predictive effect of neutrophil to lymphocyte ratio (NLR) for recurrence-free survival after liver transplantation in hepatocellular carcinoma (HCC) patients.Methods:The clinical data of 84 HCC patients who underwent liver transplantation in the 900th Hospital of the Joint Logistics Team, PLA, from January 2012 to December 2019 were included in this retrospective analysis. There were 73 males and 11 females, with an average age of 51 years. Univariate and multivariate Cox regression analyses were performed. The distinguishing ability of NLR for predicting recurrence-free survival in patients with HCC after liver transplantation was analyzed using the receiver operating characteristic (ROC) curvee. The two groups were generated according with the cut-off value, and the recurrence-free survival time to make the Kaplan-Meier survival curve.Results:The area under the ROC curve of NLR for predicting recurrence-free survival after liver transplantation in patients with HCC was 0.683, Yoden index was 0.319, and the optimal threshold was 3.2.Univariate analysis showed that maximum tumor diameter, number of tumors, Milan criteria, and NLR were associated with recurrence-free survival after liver transplantation in patients with HCC (all P<0.05). Multivariate analysis showed that maximum tumor diameter ( HR=2.412, 95% CI: 1.277-4.555), number of tumors ≥3 ( HR=5.595, 95% CI: 2.023-17.531) and NLR≥3.2 ( HR=2.891, 95% CI: 1.348-6.204) were independent risk factors for recurrence-free survival of HCC patients prediction after liver transplantation (all P<0.05). The 1-year recurrence-free survival rate was 78% in the NLR<3.2 group ( n=61), which was superior to 58% in the NLR≥3.2 group ( n=23), and the difference was statistically significant ( P<0.05). Conclusion:Tumor diameter, number of tumors and NLR are risk factors affecting the prognosis of liver transplantation in patients with HCC, and high serum NLR may indicate recurrence-free survival in patients with HCC after liver transplantation.