Objective To compare the safety and immunogenicity between domestic and imported,imported and imported split influenza virus vaccine in Chinese population. Methods The published studies during January 1996 and June 2008 on the comparison between split influenza virus vaccine were screened and evaluated.The meta analysis was performed on safety and immunogenicity using fixed model or random model according the heterogeneity of the studies. Results 12 studies which were all random controlled trials between split vaccine were included.10 trials were between domestic and imported vaccine,and 2 trials were between imported and imported vaccine.For 10 domestic and imported vaccine trials,the local reaction pooled OR=0.81,95% CI (0.59,1.11);the systemic reaction the pooled OR=0.78,95% CI (0.50,1.03);the H1N1 subtype seroconversion pooled OR= 0.94,95% CI (0.78,1.14);the H3N2 subtype seroconversion pooled OR =1.01,95% CI (0.87,1.17);the B type seroconversion total OR= 1.35,95% CI (0.98,1.85).For 2 imported and imported vaccine trials,the local reaction pooled OR = 1.19,95% CI (0.60,2.37);the systemic reaction the pooled OR =1.15,95% CI (0.71,1.87);the H1N1 subtype seroconversion pooled OR= 1.27,95% CI (0.37,4.37);the H3N2 subtype seroconversion pooled OR= 1.29,95% CI (0.39,4.33);the B type seroconversion pooled OR= 0.95,95% CI (0.46,1.37). Conclusions There were no statistical difference on the safety and immunogenicity between domestic and imported,imported and imported split influenza vaccine in Chinese population.

Robot-assisted surgery is becoming a widely popular technology and now entering total knee replacement. The development of total knee replacement is introduced in this paper with the emphasis on femur positioning technologies. The experiments and error analysis of robot-assisted surgical system for total knee replacement demonstrate that femur positioning technologies have a high precision and thus deserve to be popularized theoretically and practically.

Objective:To study the feasibility and efficacy of the modified posterolateral laparoscopic approach for resection of massive splenomegaly.Methods:The data of 48 patients who underwent laparoscopic splenectomy for massive splenomegaly at the Affiliated Hospital of Jiangnan University (Wuxi 4th People's Hospital) from January 2016 to July 2019 were retrospectively analyzed. There were 29 males and 19 females, with an average age of 55.8 years. These 48 patients were divided into two groups according to the operative approach, the study group ( n=26) using the modified posterolateral approach which treated the splenic pedicle as the last step; and the control group ( n=22) which used the posterior tunnel of splenic pedicle established by anterior approach to treat the splenic pedicle first. The operation time, gastrointestinal function, recovery time, intraoperative blood loss, rates of conversion to laparotomy and postoperative complications were compared between two groups. The follow-up data were also analyzed. Results:There were no significant differences in operation gastrointestinal function recovery and hospitalization time between the two groups (all P>0.05). The intraoperative blood loss, numbers of patients with convention to open surgery and intraoperative blood transfusion, were (50.2±15.1) ml vs (160.1±40.3) ml, 2 patients (7.7%) vs 7 patients (31.8%), and 1 patients (3.8%) vs 5 patients (22.7%), in study group and control group respectively. The differences between groups were significant (all P<0.05). The complications of the study group and control group were 9 patients (34.6%) vs 13 patients (59.1%), which were significantly in the two groups ( P<0.05). On follow-up which ranged from 1 to 15 months, the numbers of patients with thrombocytosis and portal vein thrombosis in the study group and the control group were 20 patients (76.9%) vs 17 patients (77.3%), and 7 patients (26.9%) vs 6 patients (27.3%), respectively. Conclusion:The modified posterolateral laparoscopic approach for resection of massive splenomegaly was safe and feasible. It should be promoted to treat massive splenomegaly.

Two human endometrial carcinoma cell lines, HEC-1-A and RL95-2, were treated with adiponectin,and then changes of cell count, apoptosis and cell cycle arrest were measured. The expression of phospho-AMPK(Thr172) and AMPK was determined by Western Blot. The results showed that adiponectin may exert direct anti-proliferative effects on HEC-1-A and RL95-2 cells by inducing cell cycle arrest and apoptosis, which may be mediated by AMPK pathway.

Objective To explore the clinical effect of lubar intervertebral disc protrusion treatment with ozone injection combined radiofrequency thermocoagulation. Methods 36 patients with lubar intervertebral disc protrusion confirmed by clinical and imaging examination were underwent radiofrequency thermocoagulation followed ozone injection guided with CT. Results All the patients were followed up for 3 ～6 months,and statistic the improvement rate was evaluated according to Macnab standard. The total effective rate was 94.4%, and the improvement rate was 86.1%. Conclusion CT guided treatment could greatly elevate the accuracy of puncture. Radiofrequency target point thermocoagulation combined with ozone injection was a minimally invasive、safet and markedly effective method for lubar intervertebral disc protrusion treatment.

Objective To study the clinical effect of percutaneous laser disc decompression(PLDD) combined with ozone injection in the treatment of cervical spondylosis.Methods 183 cases of cervical spondylosis were randomly divided into two groups.One group of 80 cases with 118 cervical discs herniation were treated with PLDDonly.while the other group of 103 cases with 142 cervical discs herniation were treated with PLDD combined with ozone injectlon.The patients were followed up for 3 to18 months(mean 7 months).The clinical effects were assessed according to the Japanese Orthopaedic Association scoring system(JOA score)and the improvement rates of the two groups were compared.Results 167 cases were followed up.The average point of the group treated with PLDD is 15.2 and the improvement rate is 74.7%.The average point of the group treated with PLDD combined with ozone injection is 16.3 and the improvement rate is 91.3%.The difference between two groups has statistical significance(P＜0.05).Conclusion The treatment of cervical spondylosis with PLDD combined with ozone injection is safe.painless and minimally invasive.The clinical effect is impmved tremendously and much better than monotherapy.

Objective To study the effectiveness of different treatment modalities for iatrogenic injury of distal common bile duct during operation.Methods We browsed Chinese Medical Full-text Data-base with the term of “distal common bile duct injury”.All the clinical studies associated with perioperative latrogenic injury of distal common bile duct and adjacent tissue published after 1990 were enrolled,and we collected the clinical data,mortality and reoperation rate with different treatments for analysis.Results Thirty-four case series and case reports with 233 patients were included.14 patients with isolated duodenal injury were excluded.The overall mortality of the remaining 219 patients was 9.6％,and the reoperation rate was 17.4％.A total of 145 patients who were diagnosed with distal common bile duct injury during and after operation from 21 articles were compared.The mortality and reoperation rate were both 1.9％ among 106 patients who were diagnosed during operation.The figures were 43.6％,and 84.6％ among 39 patients who were diagnosed after operation,respectively.In 9 articles with 46 patients,the clinical outcomes of 21 patients who were treated by intraoperative suture was compared with 25 patients who underwent enhanced biliary and retroperitoneal drainage.The mortality and reoperation rates were 0 in both groups.Conclusions Early detection and management are crucial to perioperative common bile duct injury.Furthermore,no significant difference of clinical outcomes observed between bile drainage and perforation suture groups.

BACKGROUND:Massive blood loss was caused by an over-reactive fibrinolytic system, as a sequence of tourniquet usage and surgery trauma in total knee arthroplasty. As an antifibrinolytic drug, tranexamic acid has been proven to decrease not only the obvious and total blood loss, but also the ratio of alograft blood transfusion in total knee arthroplasty. Nevertheless, the effect of tranexamic acid on hidden blood loss in total knee arthroplasty had not been clarified yet. OBJECTIVE: To observe the effect of intravenous infusion of tranexamic acid on hidden blood loss in primary total knee arthroplasty. METHODS:Clinical data of 54 patients who received primary unilateral total knee arthroplasty in the Third Hospital, Peking University from June to December 2013 were retrospectively analyzed. They were divided into two groups according to the use of tranexamic acid. 22 patients in the tranexamic acid group were given 2 g tranexamic acid by intravenous infusion during surgery. 32 patients in the control group were given an equal volume of physiological saline. Patients in both groups were oraly given anticoagulant rivaroxaban after replacement. Hemoglobin level and blood hematocrit were recorded before and after surgery for 5 consecutive days. The total amount of blood loss and hidden blood loss were calculated by using Cross equation. The difference in the amount of blood loss was compared between the two groups. Lower extremity venous ultrasound examination was conducted at 1 week after replacement to determine deep venous thrombosis in the lower limb. RESULTS AND CONCLUSION:No significant difference in general data and perioperative conditions was detected between the two groups (P > 0.05). Postoperative drainage, dominant blood loss, total blood volume, the amount of autologous blood transfusion and the amount of alogeneic blood transfusion were significantly less in the tranexamic acid group than in the control group (P < 0.05). According to Gross formula, the difference of hidden blood loss was statisticaly significant between the tranexamic acid group (302.9±189.9) mL and the control group (596.8±271.4) mL (P < 0.05). Deep vein thrombosis appeared in one case between the two groups after replacement. Results indicate that intravenous infusion of tranexamic acid dramaticaly decreased the hidden blood loss in unilateral total knee arthroplasty, reduced alogeneic blood transfusion, and simultaneously did not increase the incidence of deep vein thrombosis in the lower limb.

It is confirmed that chronic atrophic gastritis (CAG) caused by Helicobacter pylori is the main cause of gastric precancerous lesions.CAG is also the key determinant in gastric cancer risk assessment,which affects pepsinogen and gastrin-17 secretion.Most of the gastric cancer patients have poor prognosis,and non-invasive tools for gastric cancer screening and diagnosis are lacking.Therefore,the early detection of gastric cancer in order to reduce the disease mortality is necessary.Pepsinogen and gastrin-17 are biomarkers of gastric mucosa and gastric antra.The serological testing for the stomach-specific biomarkers offers the possibility to know preneoplastic gastric mucosal conditions.

Objective To explore the appropriat.e treatment process for elderly patients with intertrochanteric fracture in primary hospitals.Methods According with the evaluation system and the characteristics of the grassroots hospitals and elderly patients with intertrochanteric fractures,the treatment standards for risk assessment was established,and the appropriate treatment process for intertrochanteric fracture in elderly patients in primary hospitals was initially formed and tried to promote applications in three primary hospital from December 2010 to January 2012,and its feasibility and effectiveness were tested.Results 66 elderly patients with intertrochanteric fracture were treated in three primary hospital,and 38 cases were hospitalized in primary hospital,including 24 cases of osseous union in 27cases treated with expectant treatment,11 cases of surgical treatment,and the cure rate was 89.5％.Sent on the operation rate of 90.3％ cases,54.8％ of cases occurred within 2 days.The incident of complications in early stage was 25.8％.Conclusion The diagnosis and treatment process and assessment criteria of treatment risk for elderly patients with intertrochanteric fracture in the primary hospital which is initial established is simple,practical,practicable,and has good effect and certain clinical value.