Objective To evaluate the effect of perioperative intravenous (Ⅳ) iron sucrose therapy on reducing postsurgical blood transfusion rates in elderly patients with hip fractures.Methods From September 2011 to February 2014,200 patients aged≥65 years with hip fractures were enrolled.The iron sucrose group (n=100) received iron sucrose (600 mg,Ⅳ),while the control group (n=100) did not receive iron sucrose.Postsurgical blood transfusion rates,infection rates,mortality and length of hospital stay were evaluated.Results The difference in blood transfusion rates was significant (25.0％ vs.41.0％,P＜0.05),while differences in infection rates,mortality and length of hospital stay were not significant between the two groups.Conclusions Perioperative Ⅳ iron sucrose can reduce blood transfusion requirements in elderly patients with hip fractures.

[Objective]To analyze the character of the complex proximal humeral fracture,study their operative methods and evluate the efficiency of treatment for complex proximal humeral fracture in elder patients with LCP plate.[Method]From(Oct 2004 to June 2006,16 elder patients with complex proximal humeral fracture were admitted and treated with open reduction and LCP plate internal fixation,regular clinical follow-up was executed by our medical team,the postoperative results were observed and the efficiency were evaluated by us.[Result]Sixteen cases obtained postoperative clinical results from 6 to 18 months(average 12.3 months),the fracture were healed in all cases,the shoulder function were evaluated with Neer shoulder functoin scoring systerm,the execellent result were 11,good 2,normal 2 and poor 1,the execellent and good results were 81.3% in all cases,6 cases got anatomic reduction,6 cases got nearly anatomic reduction,3 normal and 1 poor which were certified by radiographic examination.[Conclusion]The treatment for complex proximal humeral fracture in elder with LCP plate has less invasive,firm internal fixation and satisfactory shoulder function recovery.It is a very satisfactory internal fixtion for complex proximal humeral fracture in elder patients.

The plasma level of endogenous digitalis-like substance(EDLS) was measured in 15 patients who underwent cardiac operation under cardiopulmonary bypass (CPB). Blood samples were taken before and after anesthesia induction,immediately before CPB and removing the aortic crossclamp,and at 5,30min after heart rebeating. Resluts showed that the plasma EDLS level slightely decreased after anethesia indction, and significantly decreased immediately before removing the aortic crossclamps and at 5 min after heart rebeating (P

Objective To evaluate the curative effect of stereotactic radiotherapy in pancreatic cancer in the elderly. Methods Retrospectively analyzed 65 elderly patients with pancreatic cancer were treated with stereotactic radiotherapy. The ages of patients were 60 to 86, with mean age of 71 2. The numbers of treatment were 8 to 12 times according to the tumor size and patients condition Fractional dose were 3 to 6 Gy, total dose were 32 to 54 Gy. The curve of isodose was 50%～80% Results The patients average alive time was 9 3 months after stereotactic radiotherapy The clinical benefit response rate was 61 2%. The CR+PR was 38 4% Conclusions The stereotactic radiotherapy is safe and effective method for treating elderly pancreatic cancer

Objective To master the current situation of Keshan disease(KD) and its trend in Yunnan Province,and scientifically evaluate the control and prevention measures.Methods According to the 2011 Endemic Disease Prevention and Control Project Implementation Plan and National Keshan Disease Mornitoring Program,choose Eryuang,Dali,Xiangyun,Wuding,Nanhua,Chuxiong and Mouding Counties(Cities)in Yunnan Province,that were seriously affected by Keshan disease,monitoring was carried out; 2 towns were selected in each county,and 1 village was selected as surveillance site in each selected town.All the residents were clinically examined and Electrocardiography tracing was taken.Suspected cases were given filmed chest X-ray and color echocardiography.KD cases were correctly diagnosed according to the diagnostic criteria.Results A total of 6 022 residents were investigated in the 14 investigation sites; 25 cases of KD were found,and the total incidence rate was 0.42％.Among the 25 KD cases,22 cases were latent KD,and the incidence rate was 0.37％; women(15 cases) were more than men (10 cases),and 10 patients were 3-14 years old,accounted for 40.00％(10/25).Potential KD 22 cases,including 10 cases of 3-14 years old; slow type of KD 3 cases,including 2 cases 45-54 years old.Electrocardiographic examination 6 022 residents,the abnormal rate was 20.44％.Among 32 X-ray films,28 cases had a cardiothoracic ratio less than or equal to 0.50,2 cases from 0.51 to 0.55,1 case from 0.56 to 0.60,and 1 case more than or equal to 0.61.Conclusions The results of KD surveillance have presented a downward trend in Yunnan Province,and the incidence rate of KD is lower.But the pathogenic factors are still active,which is harmful to children health in KD areas.In future,surveillance of children KD should be strengthened,control measures should be implemented,in order to guarantee the health of people who lived in KD areas.

Objective To investigate the methods and therapeutic effects in reconstructing and restoring the knee stability of floating knee injury. Methods A total of 38 patients with floating knee injury combined with acute knee instability treated from January 2000 to January 2006 were retrospectively studied to evaluate the efficacy of different procedures. Results All patients were followed up for 1-4 years (mean 1.5 years), which showed fracture healing in all patients. There occurred postoperative wound infection in three, internal fixator loosening in two, anterior cruciate ligament laxity in one and osteearthritis in two. According to Score of Hospital for Special Surgery (HSS) for knee function,the knee function was excellent in 32 patients, good in five and fair in one, with excellence rate of 84%. Conclnsions During the treatment of floating knee injury, attention should not only be paid to the reconstruction of the bone continaity, but also to the restoration of ligaments, meniscus, joint capsule and muscles.

Objective In order to master the current prevalence situation of dilated cardiomyopathy in Yunnan Province.Methods An investigation of dilated cardiomyopathy was carried out in 17 counties from August to December in 2011 in non-Keshan disease areas.Two townships (towns) that similar to Keshan disease areas in natural environment,pattern of production and lifestyle in non-Keshan disease areas were selected in each project county,and 1 village was selected as surveillance site in each selected township(town).The number of resident in each village no less than 500 people was appropriate and deficiency was supplemented from neighboring villages.The sampling rate was no less than 80％.Clinical examination and electrocardiographic tracings were carried out.The patients with suspected dilated cardiomyopathy and latent Keshan disease were taken anteroposterior chest X-ray in accordance with the National Non-Keshan Disease Area Dilated Cardiomyopathy Condition Survey Program.The surveillance was carried out based on The National Investigation Scheme of Dilated Cardiomyopathy in Non-Keshan Disease Areas.Cases were diagnosed based on the diagnostic standard of dilated cardiomyopathy and suspected latent Keshan disease.Results In the 34 villages of 17 selected counties,14 545 people were investigated.Twenty-six cases of latent dilated cardiomyopathy and suspected latent Keshan disease were detected,and the total detection rate was 17.88/million.One case was dilated cardiomyopathy,and 25 cases were suspected latent Keshan disease,detection rates were 0.69/million and 17.19/million,respectively.Male and female cases were 15 and 11,respectively.The ratio of people aged 65 and older accounted for 42.31％(11/26),among them suspected latent Keshan disease accounted for 44.00％(11/25),and 1 case of dilated cardiomyopathy was in the 45 to 54 years old group.Electrocardiographic examination of 14 519 people,the abnormal rate was 8.13％(1 180/14 519).Among 112 chest X-ray films,104 cases had a cardiothoracic ratio less than or equal to 0.50,4 cases from 0.51 to 0.55,3 cases from 0.56 to 0.60,and 1 case more than or equal to 0.61.Conclusion The detection rate of dilated cardiomyopathy cases is lower in non-Keshan disease area of Yunnan Province,but suspected latent Keshan disease is detected.

Objective To study the methods and effect of minimally invasive percutaneous plate osteosynthesis(MIPPO) on tibial Pilon fracture.Methods 49 cases of tibial Pilon fracture hospitalized,23 cases(group A) with minimally invasive percutaneous plate osteosynthesis(MIPPO) by indirect reduction and 26 cases(group B) with open restoration internal fixation by prospective contrast investigation.Results Compared with group B,the amount of blood loss and complications in group A markedly decreased,the healing of fracture was faster,the functional rehabilitation of ankle joint was more satisfactory.Conclusion Minimally invasive percutaneous plate osteosynthesis(MIPPO)on tibial Pilon fracture can meet the requirements of biological osteosynthesis,degrade soft tissue operation injury,be beneficial to fracture healing and functional rehabilitation of ankle joint.MIPPO is a safe and effective technique of tibial Pilon fracture.

Objective To discuss the efficiency of fibrin glue amikacin complex in controlling infection by observing the changes of leukocyte and neutrophilic granulocyte classifying counts after fibrin glue amikacin complex treated deep wound. Methods Clinical case-control study was used in the study. All patients were divided randomly into test group (100 patients) and control group (100 pa-tients), matched by wound location, wound size, time from injury to operation, combined injury and gen-eral antibiotics use to compare leukocyte and neutrophilic granulocyte classifying counts between both groups and observe possible toxic and side-effect in test group. Results Firstly, the test group and control group had the comparability in aspects of gender distribution, average age and injury mechanism (P >0.05). Secondly, there was statistical difference in classifying counts of leukocyte and neutrophilic granulocyte in the test group at different time points (P <0.05). The classifying counts of leukocyte and neutrophilic granalocyte peaked at 24 hours after operation, then decreased with treatment time and reached the lowest at 24 days after surgery or at day 1 before discharge. Thirdly, there existed statistical significance upon leukocyte counts in the test group and control group except for at day 1 after operation (P > 0.05), with lower counts in test group than control group. In aspect of neutrophil classifying counts, there was statistical significance (P < 0.05) at other time points in beth groups except for time points at days 1,2 and 12 (P >0.05). The test group had lower neutrophil classifying counts compared with con-trol group at different time points. Conclusion The fibrin glue amikacin complex has good clinical effort and high security, with no toxic or side effort in treatment of deep wound infection, and is worth clinical applicaiton.

Objective To evaluate the accuracy of cone?beam breast CT (CBBCT) on tumor sizing in patients with invasive breast carcinoma and analyze the influence factors. Methods The preoperative CBBCT images of 82 female patients (85 breast lesions) with invasive breast carcinoma confirmed by pathology from November, 2011 to December, 2017 in Tianjin Medical University Cancer Hospital were included in this retrospective study. All the patients underwent the pathology and immunohistochemical test after operation. Tumor size estimation were performed on preoperative CBBCT images. Referring to tumor size measurement on pathology, all the lesions were divided into two groups. Concordance was defined as the discrepancy in diameter less than 0.5 cm, and the discordance was more than 0.5 cm. Pathology examination was performed after resection, and estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2(HER?2) and Ki?67 result were recorded. All the lesions were classified into molecular subtype, including 14 Luminal A, 50 Luminal B, 11 HER?2?enriched and 10 triple?negative. Intraclass correlation coefficient (ICC) and Pearson correlation coefficient were used to analyze the reliability of CBBCT on tumor sizing. CBBCT?pathology discordance was analyzed based on the clinical, histopathology and CBBCT features by using t test, Chi?square and Fisher exact test. ROC curve was used to analyze the cut?off value between tumor size and CBBCT?pathology discordance. Results The agreement between CBBCT (2.155 ± 0.799) cm and pathology (1.986 ± 0.933) cm measurement was on moderate degree based on the ICC value (ICC=0.781, P<0.01) and had positive correlation (r=0.803, P<0.01). CBBCT?pathology concordance was found in 71 lesions, and discordance in 14 lesions. The factors of family history, symptom, pathology type, molecular subtypes, histological grade, surrounding fat invasion, lymphatic invasion, axillary lymph node metastasis, HER?2 positive and Ki?67 high expression had no significant difference between two groups. ER or PR positive had significant difference, suggesting that the accuracy of evaluation on ER or PR negative lesions could be reduced. The cut?off value of ROC curve between tumor size and CBBCT?pathology discordance was 2.08 cm, and the area under curve was 0.70. In 85 lesions. 66 of 75 mass lesions and 5 of 10 non?mass lesions were consistent. The lesion type had significant difference between two groups (χ2=6.705, P=0.010), which suggested the CBBCT evaluation on non?mass could have discrepancy with pathology. Conclusion CBBCT has high accuracy on tumor size evaluation on invasive carcinoma. ER or PR negative, large lesions or non?tumor lesions should be alert to the impact of CBBCT?pathology discordance before surgery which may cause the alteration of surgical protocols.