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 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 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 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.

BACKGROUND: After the treatment of osteoporotic vertebral compression fractures with bone cement implantation,deteriorative osteoporosis and the distance augment between bone cement and bones result in a decrease in bone cement-bone interface compression strength and torsion strength, and then the bone cement tends to displace, which is easy to cause a secondary vertebral fracture.OBJECTIVE: To investigate the clinical efficacy of bone cement implantation via three approaches on osteoporotic vertebral compression fractures.METHODS: Sixty patients with single osteoporotic vertebral compression fracture were treated with vertebroplasty,percutaneous kyphoplasty or fraction cement vertebroplasty. All data were collected to analyze the correlation between the bone cement morphology and treatment method, and to detect the visual analogue scale, Oswestry disability index,Cobb angle and incidence of secondary vertebral fractures.RESULTS AND CONCLUSION: The visual analogue scale scores, Oswestry disability index, and Cobb angle in thethree groups were significantly improved after treatment (P < 0.05). All above indicators showed no significant difference among groups at each time point after treatment, suggesting that these three kinds of treatments exert the same effects on pain relief, functional recovery, preventing the vertebral height loss and maintaining spinal mechanical properties.Bone cement displacement and secondary vertebral fracture occurred after clotted cement implantation. Therefore,mixed and trabecular-shaped grafts are preferred, aiming to achieve good long-term treatment outcomes in osteoporotic vertebral compression fractures.

Objective To evaluate the efficiency of dezocine combined with sufentanil on postoertive analgesia for spinal deformity sur-gery.Methods Divided the 90 patients who were admitted into our hospital from January 2013 to September 2015 into three groups by ran-dom single blind method,namely the dezocine group,the sufentanil group and the combined group,with 30 cases in each group.All the pa-tients underwnet propofol and sevoflurane static absorption compound anesthesia,and they were given continuous intravenous analgesia with different drugs after the surgery.Their visual analogue scale (VAS)score,sedation scale (SS)score,adverse reaction,total PCIA times,ef-fective PCIA times,respiratory rate and arterial blood gas were measured at 2,6,24,48 hours after operation.Results The VAS score of the combined group was lower than that of the dezocine group (P <0.05).The combined group was significantly superior to the dezocine group and the sufentanil group in SS score and adverse reactions.At 24 and 48 hours after surgery,SaO2 and PaO2 in the combined group were higher than those in sufentanil group (P <0.05).PaCO2 in the combined group was lower than that in the dezocine group and the sufentanil group(P <0.05).Conclusion Dezocine combined with sufentanil is a more efficiency way with less adverse reaction on postoperative anal-gesia for spinal deformity surgery,and it is an ideal way of analgesia.

Objective To investigate the effects of in vivo electroporation on plasmid mediated reporter gene expression and immunogenicity of DNA vaccine. Methods Luciferase expression plasmid was administered intramuscularly to BALB/c mice at 8μg and 40μg dosage level through injection with or without eletroporation Luciferase expression level in murine muscle was detected by IVIS imaging system 24 h after injection. DNA vaccine plasmid p1.0-gp1455m carrying codon-optimized env gene of CN54 strain ( HIV-1 CRF07_BC) was administered to mice at dosages of 8μg and 40μg through the two approaches mentioned above. Mice were immunized at week 0,2 and 4. Env-specific immune responses were detected at two weeks post the second and the third vaccinations. Env-specific antibody immune responses were determined by ELISA. Euv-specific cellular immune responses were determined by IFN-γ ELISPOT. Results Luciferase expression level in murine muscle was significantly increased as much as 35 folds through in vivo eletroporation. Results of ELISA and ELISPOT revealed that in vivo eletroporation could significantly enhance both the humoral and cellular immune responses induced by DNA vaccination. The responses induced by electrodelivered p1.0-gp1455m at 8 μg dosage were better than those induced by simple intramuscular injection with 40 μg of plasmid DNA. On the other hand, 2 injections followed by electroporation elicited comparable level of humoral and cellular immune responses with those induced by 3 injections without electroporation. Conclusion In vivo electroporation was capable of enhancing both the plasmid-mediated gene expression and immunogenicity of DNA vaccine.