[Objective]To explore the advantages and disadvantages of minimal incision surgery(MIS) for total hip replacement.[Methods]Thirty-two patients(37 hips) who had undergone a MIS were compared with 32 patients(37hips) who had undergone conventional incision surgery with similar condictions.The length of incision,operation time,intraoperative blood loss,postoperative drainage,hospitalized days and complications were observed.[Results]The average incision length was 7.7 cm for MIS group and 11.5 cm for conventional incision group(P0.05).In MIS group,greater trochanter fracture occured in 1 patient during operation.Dislocation occurred in another patient with anterolateral approach 3 days postoperatively because of malposition of the cup,the cup was then adjusted to proper position by re-operation with extended incision length.In conventional incision group,no complication occured during or after operations.[Conclusion]Total hip replacement with the incision length of 6～8.5 cm is a very demanding technique.There were no much advantages of MIS for total hip replacement concerning surgical time,blood loss or trauma compare with a conventional incision surgery.The incision length for total hip replacement should not be stressed.The most important thing for total hip replacement is not the length of the incision and the length of incision should not be reduced at the price of more soft tissue injury.

Objective To study 64-slice CT perfusion features of metastatic tumors of liver and its clinical value.Methods 23 cases (40 lesions) with liver metastases underwent CT perfusion scanning.Hepatic arterial perfusion index(HPI) parameters including blood flow perfusion(BF),patlak blood capacity (pBV),vascular permeability (P,permeability),arterial liver perfusion(ALP),portal venous perfusion( PVP ) were analyzed in comparison with that of normal liver .Results (1)BF, pBV , P , ALP , PVP and HPI in normal liver tissue were (47.85?8.11) ml?100ml-1?min-1,41.25?6.32 (1000:1), 64.25?11.10 (0.5 ml?100ml-1?min-1),(24.55?2.96) ml?100ml-1?min-1, (105.24?16.42) ml?100ml-1?min-1,(20.18?3.81),respectively.(2)BF,pBV,P,ALP and PVP between the normal hepatic tissue and the centre of lesions were of statistically significance (P

Neuro-ophthalmology,as an interdisciplinary,covers ophthalmology,neurology and neurosurgery.In China,the development of neuro-ophthalmology has just started,therefore how to train neuro-ophthalmological specialists in China is a problen.This paper analyzed the medical education and current situation of neuro-ophthalmology of China and America,discussed the differences between them,and then put forward some problems existing in the neurological ophthalmology physician training and solutions,aiming at improving the specialist physician train program of Neuro-ophthalmology by learing from foreign medical education development experience,and promoting the development of neuro-ophthalmology in China.

Objective To study the influence of nursing interventin on compliance of patients with allergic rhinitis undergoing immunotherapy.Methods Patients with allergic rhinitis undergoing immunotherapy from October of 2003 to October of 2005 and from Novermber 2005 to August 2007 were named the control group and test group respectively.Only the test group received nursing intervention.The compliance of the patients was investigated with subsequent cause analysis.The compliance de-gree and its influencing factors in the two groups were compared.Results The complete complianceof the test group was 80.5%,which was statistically different from that of the control group(68.9%,P<0.01).The difference between adult patients of the two groups was also evidently different(P<0.05).But the difference between children patients of the two groups was not evidently different(P>0.05).Statistical difference existed between children and adult patients in the control group as well as in the testgroup(P<0.01).The uncontrollable factors in the test group reduced while the controllable factors increased.Conclusion The nursing intervention could improved patients compliance with immunotherapy in that it reduced the uncontrollable factors among the reasons causing uncompliance.It worth widely being applied in clinic.

Objective To describe the status quo of readiness for hospital discharge of liver cancer patients accepted transcatheter arterial chemoembolization(TACE)treatment and to explore its influencing factors. Methods A cross-sectional survey was conducted. A self-designed general information questionnaire and the Readiness for Hospital Discharge Scale were delivered to 113 liver cancer patients accepted TACE from the Second Hospital of Dalian Medical University. Results The score of readiness for hospital discharge of liver cancer patients accepted TACE treatment was(171.73±14.71)points,and each item was divided into (7.81±0.67) points. Multiple linear regression analysis showed that age and education level were important factors influencing the degree of readiness for hospital discharge(t=-5.591,5.982,P<0.05). Conclusions The level of readiness for hospital discharge of liver cancer patients accepted TACE treatment is relatively satisfactory. Medical staff should provide targeted health education and intervention measures to improve their discharge readiness and ensure their safety after discharge.

Purpose To develop the folate-targeted theranostic nanoprobe, investigate the active targeting behavior of nanoprobes to hepatocellular carcinoma(HCC)in vitro,and discuss the effect of enhanced US/MRI dual-mode imaging in vitro and the synergistic effect of high intensity focused ultrasound on HCC killing. Materials and Methods The folate-targeted nanoprobe loaded with iron oxide nanoparticles (Fe3O4) and phase-shift material perfluorohexane (PFH) was prepared by double emulsion method and carbodiimide method. The average particle size, morphological structure and the ability of liquid-gas phase transition were detected. The active targeting ability of the nanoprobe to HCC BEL-7402 was observed in vitro.The ultrasonic imaging effect of nanoprobe was observed by HIFU irradiation in vitro.MRI was performed on the Fe3O4nanoprobe with different content of magnetic particles.The synergistic killing ability of the nanoprobe combined with HIFU on liver cancer cells was detected with in vitro apoptosis experiment. Results The folate-targeted nanoprobe loading iron oxide nanoparticles (Fe3O4) and phase-shift material PFH was prepared, with the average size of (402.50±66.43) nm. It was in the shape of regular sphere with the magnetic particle Fe3O4scattered inside. The HIFU irradiation caused liquid and gas phase transition.In vitro targeting experiments showed that BEL-7402 cells were surrounded by a large number of nanoscale probes.In vitro dual mode imaging showed that the ultrasonic echo intensity was obviously enhanced after HIFU irradiates nanoscale probes. The MR negative imaging ability of the nanoprobe was also enhanced with the enhancement of Fe3O4concentration in nanoparticles. In vitro apoptosis experiments showed that the nanoscale probe had the ability to significantly enhance the effect of HIFU on the killing of HCC. Conclusion The prepared folate-targeted theranostic nanoprobes exhibit the excellent capability for in vitro targeting.They can be used for ultrasound and MRI as multimodal imaging agents and coordinates with HIFU to enhance the effect on killing HCC, which realizes the early diagnosis of tumor and targeted precision therapy.

Objective:To investigate the effects of curcumin on proliferation, cell cycle, and apoptosis of human thyroid cancer TPC-1 cells.Methods:Logarithmic growth phase TPC-1 cells were treated with 0.0, 7.5, 15.0 and 22.5 μmol/L curcumin for 48 h. Cell proliferation levels were determined using the methylthiazolyl tetrazolium (MTT) assay. Cell cycle and apoptosis levels were measured using flow cytometry. Western blot method was used to determine the expression levels of B cell lymphoma-2 (Bcl-2) and Bcl-2-associated X protein (Bax).Results:The inhibition rates of cell proliferation in 7.5, 15.0 and 22.5 μmol/L curcumin groups were higher than that of 0.0 μmol/L curcumin group ( P < 0.05); the proportion of G0/G1 phase was higher than that of 0.0 μmol/L curcumin group, but the proportions of G2/M and S phase were lower than those of 0.0 μmol/L curcumin group ( P < 0.05); the cell apoptosis rate was higher than that of 0.0 μmol/L curcumin group [(14.13 ± 0.57)%, (25.27 ± 0.62)%, (36.01 ± 0.84)% vs (8.48 ± 0.43)%, P < 0.05]; the protein expression of Bcl-2 was lower than that of 0.0 μmol/L curcumin group, and protein expression of Bax was higher than that of 0.0 μmol/L curcumin group ( P < 0.05). Conclusion:Curcumin can inhibit the proliferation of TPC-1 cells, block the cell cycle in G0/G1 phase, and promote cell apoptosis by downregulating Bcl-2 expression and upregulating Bax expression.

Sleep deficiency is a common public health problem associated with many diseases, such as obesity and cardiovascular disease. In this study, we established a sleep deprivation (SD) mouse model using a ‘stick over water’ method and observed the effect of sleep deficiency on ocular surface health. We found that SD decreased aqueous tear secretion; increased corneal epithelial cell defects, corneal sensitivity, and apoptosis; and induced squamous metaplasia of the corneal epithelium. These pathological changes mimic the typical features of dry eye. However, there was no obvious corneal inflammation and conjunctival goblet cell change after SD for 10 days. Meanwhile, lacrimal gland hypertrophy along with abnormal lipid metabolites, secretory proteins and free amino-acid profiles became apparent as the SD duration increased. Furthermore, the ocular surface changes induced by SD for 10 days were largely reversed after 14 days of rest. We conclude that SD compromises lacrimal system function and induces dry eye. These findings will benefit the clinical diagnosis and treatment of sleep-disorder-related ocular surface diseases.

Objective:To evaluate the efficacy and safety of drug-coated balloon (DCB) with paclitaxel in the treatment of femoropopliteal arteriosclerosis obliterans (ASO).Methods:From Dec 2016 to Dec 2018, clinical data of femoropopliteal artery disease patients treated with paclitaxel DCB in Renji Hospital, School of Medicine, Shanghai Jiaotong University were retrospectively analyzed.Results:A total of 83 patients (95 lower limbs) underwent DCB therapy. Including 50 chronic total occlusion (CTO) lesions (52.6%) with mean lesion length of (18.35±10.61) cm. Twenty-four lesions (25.3%) were moderately or severely calcified. Bail-out stent implantation was performed in 29.5% cases. The mean follow-up time was 17.5 months. Twelve months after intervention, the all-cause mortality rate was 6.0%, the major amputation rate was 4.3%, the primary patency rate was 60.6%, the primary assisted patency rate was 72.4%, the secondary patency rate was 83.4%, and the freedom rate from clinically-driven target lesion revascularization(F-TLR) was 77.0%. Moderate to severe calcification was an independent risk factor for the primary patency of DCB therapy.Conclusion:DCB is a safe and effective endovascular therapy for femoropopliteal artery disease.

Objective:To evaluate the long-term outcome of Viabahn stent graft in the treatment of complex femoropopliteal occlusive lesions.Methods:From Sep 2013 to Mar 2020, clinical data of TASC C and D femoropopliteal lesions treated with Viabahn were retrospectively analyzed. Patency rates, the freedom rate from clinically-driven target lesion revascularization (F-TLR), limb salvage and survival after five years were calculated.Results:A total of 65 patients (67 lower limbs) were included. 20 limbs were TASC C lesions, 47 limbs were TASC D lesions. The mean lesion length was (29.1±9.4) cm, including 48 chronic total occlusion (CTO) lesions (71.6%) with mean lesion length of (26.1±10.4) cm. Technique success rate was 98.6%. Mean length of stent graft was (31.3±10.1) cm.Major amputation was performed in 4.2% cases within 5 years. All-cause mortality in 5 years was 23.1%. Primary patency rates at 1,3,and 5 years were 76.8%,59.4%,50.9%, Assisted primary patency rates were 88.4%, 83.4%, 83.4% and secondary patency rates were 88.4%, 85.8%, and 85.8% . F-TLR at 1, 3 and 5 year was 88.2%,76.9%,73.1% .Conclusion:Viabahn for complex and long femoropopliteal artery occlusions is an acceptable treatment with fair long-term outcome.