Objective To investigate the prevention and management strategies of in-hospital complications in the hip replacement in elderly patients(≥80 years old) Methods The data of 42elderly patients with hip replacement between Oct.2004 and Dec.2006 were collected and analyzed.Their age ranged from 80 to 96 years with an average of 84.6 years.Twenty-four cases were associated with severe osteoporosis(Dorr Ⅲ),13 with coronary heard disease,10 with arrhythmia,7with diabetes,5 with cerebral paralysis.Twenty five cases had a cemented stem bipolar femoral head replacement,2 had uncemented stem bipolar femoral head replacement,7 had cemented total hip replacement,3 had revision of total hip replacement. Results No death occurred during operations,1 died postoperatively due to dislocation at the 5th day postoperation.One case had coma for 1 week after general anaesthesia.5 had temporary cognitive handicap,38(90.5%)were able to walk at the aid of walker with easement of pain before discharging. Conclusions To gain good results in elderly patients with hip arthroplasty,less invasive and quick anaesthetic technique and operative procedures are encouraged.Meticulous preoperative preparation.active preventing and treating the intraoperative and postoperative complications should be emphasized.

Objective To investigate the clinical efficacy of bromhidrosis with botulinum toxin A by needle free injection.Methods A total of 40 patients with bromhidrosis were collected and divided into needle free group and needle group.A comparative study was carried out in those subjects.Patients in needle free group received needle free injection of botulinum toxin A by INJEX30;Needle group received traditional injection by 26 G needles.Results In needle free group,16 cases were cured,3 cases were effective,1 case was ineffective,no significant pain,hematomas or necrosis were found.In needle group,15 cases were cured,4 cases were effective,and 1 case was ineffective;localized hematoma occurred in 2 cases.And cases in group needle experienced pain more intensely than cases in needle free group.Conclusions The INJEX30 improves the security,comfort and therapy compliance of botulinum toxin A injection in the bromhidrosis patients,with similar efficacy with traditional injection.

Objective To compare the molecular characteristics of hantanvirus strains isolated from 1980 to 2002 in Zhejiang Province by PCR and nucleotide sequencing.Methods Total RNA was extracted from hantanvirus infected Vero-E6 cells. The M segment cDNA of hantaan ZJ4 and ZJ7 strains were obtained by reverse transcription and polymerase chain reaction, subsequently cloned into pUCm-T vector and sequencing.Results Two strains ZJ4 and ZJ7 of hantanvirus isolated from Rottus in Zhejiang province were HTN viruses. HTN virus strain Z10 was isolated in 1980. Comparison ZJ4 and ZJ7 with Z10 strains indicated that there were 88.3% and 92.3% homology at the nucleotide level.Conclusion The HTN virus were very conserved. The homology of HTN virus isolated from Zhejiang Province was high nucleotide level, though they were isolated at more than 20-year intervals.

Objective To evaluate the performance of trilobed flaps for reconstruction of nasal tip defects. Methods Totally, 23 patients with nasal tip defects after tumor resection were enrolled into this study. Skin defects varied from 1.5 cm × 1.5 cm to 2.5 cm × 2.5 cm in size. According to the location and size of skin defects, trilobed flaps were designed, and the angle between two lobes ranged from 45° to 50°. The size of the first lobe was approximately equal to that of the skin defect, while the size of the second and third lobes decreased successively. During flap design, the integrity of nasal subunits was sufficiently considered, and the incision lines were placed along the boundary lines of the nasal subunit as far as possible, so as to conceal the incision scar with natural skin folds. Results After the operation, skin flaps survived with primary healing of incisions in all the patients. After 6 - 24 months of follow up, the color, texture and thickness of flaps were similar to those of their surrounding skin, and incision scars were inconspicuous. No malformation occurred in the nasal ala, nostril, nasal columella or surrounding organs, and satisfactory nasal appearance and function were achieved. Conclusion Trilobed flaps can be used to effectively repair relatively large skin defects of the nasal tip with satisfactory nasal appearance and function.

40 cases(control group)with aggressive periodontitis (AgP)received scaling and root planning (SRP)and 38 cases(test group)received SRP followed by oral administration of amoxicillin plus metronidazole for 7 d.Gingival crevicular fluid samples were exam-ined for the levels of MMP-1,MMP-8 and tissue TIMP-1 by ELISA before therapy,3 and 6 months after therapy,TIMP-1 /MMP-1 and TIMP-1 /MMP-8 ratios were calculated.The levels of MMP-1 and MMP-8 were decreased in both groups (P <0.05)at 3 and 6 months after therapy.TIMP-1 /MMP-1 and TIMP-1 /MMP-8 ratios were increased in the 2 groups(P <0.05)after treatment,3 months after therapy the ratio in test group was higher than that in control group(P <0.05).

Objective To observe the changes of proportion of NK cells,?? T cells,CD4+CD25+T cells and their FOXP3-expressed sub-population in peripheral blood of acute Plasmodium vivax infected patients.Methods The proportions of NK cells,?? T cells,CD4+CD25+T cells and FOXP3-expressed sub-population within CD4+CD25+T cells were measured by flow cytometry(FCM)in peripheral blood of 25 patients with acute infection of Plasmodium vivax(AC)and compared with those of both 14 normal controls(NC)and 13 immune controls(IC).Results The proportion of NK cells in AC(8.48%)decreased significantly compared with that in NC(15.53%)and IC(17.69%)(P0.05).Conclusions During acute Plasmodium vivax infection,the proportion of NK cells decreases and the proportion of ?? T cells increases,and CD4+CD25+FOXP3+T cells decrease a little.

Objective:To investigate the clinical therapeutic effect of low-dose chemotherapy in advanced gastrointestinal cancer patients with weak physical condition, and to evaluate the related factors affecting the prognosis.Methods:The clinical data of 118 advanced gastrointestinal cancer patients with weak physical condition who were admitted to Xiamen Branch, Zhongshan Hospital, Fudan University from March 2018 to May 2019 were retrospectively analyzed. Kaplan-Meier method was used to make survival analysis in patients stratified by different factors, and log-rank was used to test. Multiple factor analysis of prognosis was performed by using Cox regression model. The association of clinicopathological factors with the prognosis was evaluated.Results:Among 118 patients, 16 (13.6%) cases were esophageal cancer, 41 (34.7%) cases were gastric cancer, 48 (40.7%) cases were colorectal cancer, 13 (11.0%) cases were pancreatic cancer. The overall survival (OS) rates of 6 months and 1-year were 44.1% and 10.2%, respectively. Survival analysis showed that patients with hemoglobin ≥100 g/L, serum albumin > 40 g/L and normal gastrointestinal function had better OS (all P < 0.05), while patients with physical status score of 3 scores and pain had worse OS (all P < 0.05). Cox multivariate analysis showed that after adjusting age and gender, hemoglobin level ( HR = 0.314, 95% CI 0.241-0.977, P = 0.001), pain ( HR = 2.016, 95% CI 1.697-7.038, P = 0.008) and gastrointestinal function ( HR = 1.751, 95% CI 1.607-6.080, P = 0.036) were independent influencing factors of OS in advanced gastrointestinal cancer patients with weak physical condition after receiving low-dose chemotherapy. Conclusions:Low-dose chemotherapy can still benefit advanced gastrointestinal cancer patients with weak physical condition. Hemoglobin level, pain and gastrointestinal function are independent prognostic factors for these patients.

Objective To investigate the expression and the clinical significance of meningioma-association protein（MAC30）mRNA and protein in colorectal carcinomas.Methods MAC30 was immunohistochemically examined in 130 primary tumours,73 distant normal mucosa specimens and 34 lymph node metastases from rectal cancer patients＇paraffin embedded blocks.MAC30 mRNA expression was detected by RT-PCR in primary tumors,adjacent and distal normal mucosa of 50 rectal cancer patients underwent colectomy.Results MAC30 cytoplasmic expression level in colorectal primary tumors and lymph node metastases was significantly higher than that in distant normal mucosa.MAC30 mRNA expression was upregulated in primary tumor,and the expression level was related to the histologic type of the tumor.Three-year survival rate of the colorectal carcinomas patients with strong expression of MAC30 was significantly lower than that of the patients with weak MAC30 expression（P 0.05）.Conclusion MAC30 overexpression might be involved in the development of colorectal carcinomas and seemed to be a prognostic factor.

Objective To compare extravascular lung water index (EVLWI) and oxygenation index (PaO2/FiO2) in estimation of acute lung injury(ALI) .Methods Sixteen patients with post traumatic ALI (within 48 h) of both sexes, aged 18-80 yr, were studied. The patients were mechanically ventilated. Right internal jugular vein and femoral artery were catheterized and connected to PiCCO monitor (IntelliVue MP50, Philips, Netherlands).EVLWI was monitored with the PiCCO system. PaO2 was determined every 24 h. ALI was diagnosed based on the following criteria:(1)PaO2/FiO2≤300 mm Hg; (2)X-ray chest film-patchy shadows in the bilateral lungs and (3) CVP≤12 mm Hg.Lung injury score(LIS) was recorded. The patients were divided into PaO2/FiO2≤ 300 group and ≤200 group and EVLWI ≥ 10 group and ＜ 10 group. Results There was no significant difference in LIS between PaO2/FiO2 ≤300 group and PaO2/FiO2 ≤200 group at 24 and 48 h of PiCCO monitoring. At 72 h of PiCCO monitoring LIS was significantly increased in PaO2/FiO2 ≤200 group as compared with PaO2/FiO2 ≤300 group, LIS was significantly higher in EVLWI≥ 10 group than in EVLWI ＜ 10 group at 24, 48 and 72 h of PiCCO monitoring. Conclusion EVLWI is more accurate than PaO2 /FiO2 in estimation of severity of ALI.

Objective To elucidate the clinicopathological and hereditary characteristics in Fabry nephropathy.Methods The clinical and pathological features of 14 patients with Fabry nephropathy were collected.The activities of α-Gal A were measured in 4 probands.Screenings of GLA mutations were done in 12 patients.Results The ratio of Fabry nephropathy in the patients with renal biopsy was 0.074 ％ (14/19 005),the average diagnostic age was (30.57±9.32) years,male to female ratio was 2.5∶ 1.All the patients had proteinuria,and the median of urine total protein (UTP)was 1.71 g/24 h (0.32-4.71 g/24 h).Two of them got nephrotic proteinuria,5 of them got microscopic hematuria,4 of them got renal function insufficiency.Angiokeratomas was the most common manifestation (10/14),followed by cardiac involvement (6/14).Hypohidrosis and diseases of central neural system could also be seen in these patients.There were 9 classic phenotype,the remaining 5 were variants/renal variants.The family information was collected in 10 pedigrees,6 of them had family histories of kidney disease.Renal pathology showed vacuolization of glomerular visceral epithelial cells was the prominent feature,global and segmental glomerulosclerosis were seen in some patients by light microscopy.The myelin bodies or zebra bodies were identified in podocytes by electron microscopy,but only were found in some podocytes of 2 females.The activity of α-Gal A was decreased compared with the normal range in 4 probands.The mutations of GLA were demonstrated in 11 patients.Three novel mutations of GLA gene were identified,which were all deletion/insertion mutations with classic phenotypes.Most variants carried the mutations located in the buried/partial buried areas of α-Gal A (3/11).The classical phenotype carried GLA mutations as W162X,F169S,S201F,N272K,L310R,while variant phenotype carried GLA mutations as I91T,R112H,Q312H.Conclusions The ratio of Fabry nephropathy in patients with renal biopsy is 0.074％.Angiokeratomas and cardiac involvement are often accompanied with Fabry nephropathy.The genotypes of GLA may have close relationships with the phenotypes of Fabry nephopathy.