Objective To investigate the risk of perioperative blood transfusion in elderly patients with hip fracture and its impact on short-term prognosis.Methods The clinical data of elderly patients with hip fracture admitted to the orthopedic department of Shenzhen Municipal Second People's Hospital from January 2021 to November 2022 were collected.The patients were divided into the blood transfusion group and non-blood transfusion group according to whether or not having blood transfusion during perioperative period.The independent influencing factors for perioperative blood transfusion were analyzed by the univariate and multi-factorial logistic regression,and the short-term prognostic differences were compared between the two groups.Results A total of 412 elderly patients with hip fracture were included in the study.There were 257 cases of perioperative blood transfusion(blood transfusion group,62.4％),and the average blood transfusion amount was(4.1±2.52)U.The univariate analysis showed that the age,fracture type,complications(cardiac insuffi-ciency,preoperative pulmonary infection,bronchiectasis),red blood cell count,hemoglobin,red blood cell vol-ume distribution width,albumin,ASA grade,NYHA cardiac function grade,surgical mode,intraoperative blood loss volume and operative time had statistical differences between the blood transfusion group and non-blood transfusion group(P＜0.05).The multivariate logistic analysis showed that preoperative low Hb level,cardiac insufficiency,intraoperative blood loss volume＞200 mL and operative duration＞120 min were the independent risk factors for perioperative blood transfusion in elderly patients with hip fracture.The hospitali-zation and bed rest time in the blood transfusion group were longer than those in the non-blood transfusion group,the hospitalization expenses was higher and the activity of daily living(ADL)score was lower(P＜0.05).Conclusion The preoperative blood transfusion in elderly patients with hip fractures has high risk.Preopera-tive low hemoglobin level,cardiac insufficiency,intraoperative blood loss volume＞200 mL and operative du-ration＞120 min are the independent risk factors for perioperative transfusion in elderly patients with hip fracture and affect the short term prognosis in the patients.

Trichinellosis is an important zoonotic parasitic disease worldwide and is principally caused by ingesting animal meat containing Trichinella infective larvae. Aspartyl aminopeptidase is an intracytoplasmic metalloproteinase that specifically hydrolyzes the N-terminus of polypeptides free of acidic amino acids (aspartic acid and glutamate), and plays an important role in the metabolism, growth and development of organisms. In this study, a novel T. spiralis aspartyl aminopeptidase (TsAAP) was cloned and expressed, and its biological properties and roles in worm growth and development were investigated. The results revealed that TsAAP transcription and expression in diverse T. spiralis stages were detected by RT-PCR and Western blotting, and primarily localized at cuticle, stichosome and intrauterine embryos of this nematode by immunofluorescence test. rTsAAP has the enzymatic activity of native AAP to hydrolyze the substrate H-Glu-pNA. There was a specific binding between rTsAAP and murine erythrocyte, and the binding site was localized in erythrocyte membrane proteins. Silencing of TsAAP gene by specific dsRNA significantly reduced the TsAAP expression, enzymatic activity, intestinal worm burdens and female fecundity. The results demonstrated that TsAAP participates in the growth, development and fecundity of T. spiralis and it might be a potential target molecule for anti-Trichinella vaccines.

Spirometra larvae are etiological agents of human sparganosis. However, the systematics of spirometrid cestodes has long been controversial. In order to determine the current knowledge on the evolution and genetic structure of Spirometra, an exhaustive population diversity analysis of spirometrid cestodes using the mitochondrial gene: cytochrome c oxidase subunit 1 (cox1) was performed. All publicly available cox1 sequences available in the GenBank and 127 new sequencing genes from China were used as the dataset. The haplotype identify, network, genetic differentiation and phylogenetic analysis were conducted successively. A total of 488 sequences from 20 host species, representing four spirometrid tapeworms (S. decipiens, S. ranarum, S. erinaceieuropaei and Sparganum proliferum) and several unclassified American and African isolates from 113 geographical locations in 17 countries, identified 45 haplotypes. The genetic analysis revealed that there are four clades of spirometrid cestodes: Clade 1 (Brazil + USA) and Clade 2 (Argentina + Venezuela) included isolates from America, Clade 3 contained African isolates and one Korean sample, and the remainders from Asia and Australia belonged to Clade 4; unclassified Spirometra from America and Africa should be considered the separate species within the genus; and the taxonomy of two Korea isolates (S. erinaceieuropaei KJ599680 and S. decipiens KJ599679) was still ambiguous and needs to be further identified. In addition, the demographical analyses supported population expansion for the total spirometrid population. In summary, four lineages were found in the spirometrid tapeworm, and further investigation with deeper sampling is needed to elucidate the population structure.

A T. spiralis serine protease 1.2 (TsSP1.2) was identified in the muscle larvae (ML) and intestinal larvae surface/excretory–secretory (ES) proteins by immunoproteomics. The aim of this study was to determine the TsSP1.2 function in the process of T. spiralis intrusion, growth and reproduction by using RNA interference (RNAi). RNAi was used to silence the expression of TsSP1.2 mRNA and protein in the nematode. On 2 days after the ML were electroporated with 2 µM of TsSP1.2-specific siRNA 534, TsSP1.2 mRNA and protein expression declined in 56.44 and 84.48%, respectively, compared with untreated ML. Although TsSP1.2 silencing did not impair worm viability, larval intrusion of intestinal epithelium cells (IEC) was suppressed by 57.18% (P < 0.01) and the suppression was siRNA-dose dependent (r = 0.976). Infection of mice with siRNA 534 transfected ML produced a 57.16% reduction of enteral adult burden and 71.46% reduction of muscle larva burden (P < 0.05). Moreover, silencing of TsSP1.2 gene in ML resulted in worm development impediment and reduction of female fertility. The results showed that silencing of TsSP1.2 by RNAi inhibited larval intrusion and development, and reduced female fecundity. TsSP1.2 plays a crucial role for worm invasion and development in T. spiralis life cycle, and is a potential vaccine/drug target against Trichinella infection.

A putative serine protease of T. spiralis (TsSP) was expressed in Escherichia coli and its potential as a diagnostic antigen was primarily assessed in this study. Anti-Trichinella IgG in serum samples from T. spiralis different animal hosts (mice, rats, pigs and rabbits) were detected on Western blot analysis with rTsSP. Anti-Trichinella antibodies were detected in 100% (30/30) of experimentally infected mice by rTsSP-ELISA. Cross-reactions of rTsSPELISA were not found with sera from mice infected with other parasites (S. erinaceieuropaei, S. japonicum, C. sinensis, A. cantonensis and T. gondii) and sera from normal mice. There was no statistical difference in antibody detection rate among mice infected with the encapsulated Trichinella species (T. spiralis, T. nativa, T. britovi, and T. nelsoni) (P>0.05). The results of rTsSP-ELISA showed that serum specific antibody IgG in mice infected with 100 or 500 T. spiralis muscle larvae (ML) were detectable early at 7-8 dpi, but not detected by ML ES antigen-ELISA prior to 10-12 dpi. Specific anti-Trichinella IgG was detected in 100% (18/18) of infected pigs by rTsSP-ELISA and ES-ELISA, but no specific antibodies was not detected in 20 conventionally raised normal pigs by two antigens. The results showed the rTsSP had the potential for early serodiagnosis of animal Trichinella infection, however it requires to be assayed with early infection sera of swine infected with Trichinella and other parasites.

Objective To explore the safety and feasibility of improved jejunostomy in operation for patients with esophageal carcinoma.Methods All these 214 patients underwent resections of esophageal carcinoma and jejunostomy were divided into 2 groups,130 patients in routine group and 84 patients in improved group.A 1.5 to 2.0 centimeter in width pedicled omentum were left during dissociating the stomach for patients of improved group.Double purse-string suture were left on the prepared jejunostomy.Pedicled omentum was placed around jejunum tube which was fixed by double suture to peritoneum.Then the operating time,discharging time,leakage,infections,tube shedding and intestinal obstruction were analysed.Results All patients in both groups were healed.There's a statistically significant difference(P<0.05)in operating time and intestinal obstruction between the improved group and the routine group.There isn't a statistically difference(P>0.05)in discharging time,leakage,infections and tube shedding.Conclusion Improved jejunostomy can reduce the operating time,and it's a safe and feasible way in jejunum tube placement.