Objective:To investigate the efficacy of intermittent pneumatic compression (IPC) combined with drugs in the prevention of lower extremity deep venous thrombosis (DVT) after joint replacement and its risk factors.Methods:A total of 80 patients receiving joint replacement surgery in Jinhua People's Hospital from January 2019 to December 2020 were included in this study. They were randomly divided into observation and control groups, with 40 patients in each group. To prevent lower extremity deep venous thrombosis, the control group was given low molecular weight heparin, and the observation group was given IPC in addition to DVT. The incidence of DVT post-surgery and coagulation function pre- and post-surgery were compared between the two groups. The incidence of adverse reactions was recorded in each group. In addition, 40 patients who developed DVT after joint replacement surgery from January 2019 to December 2020 (DVT group) and 40 patients who did not develop DVT (no DVT group) were included. The factors influencing the occurrence of DVT were analyzed by binary logistic regression.Results:The incidence of DVT in the observation group was significantly lower than that in the control group (5.00% vs. 20.00%, χ2 = 4.11, P < 0.05). At 7 days after surgery, prothrombin time, activated partial thromboplastin time, fibrinogen in the observation group were (11.73 ± 0.51) seconds, (27.05 ± 1.17) seconds, (3.89 ± 0.52) g/L, respectively, which were significantly lower than (12.03 ± 0.43) seconds, (27.65 ± 1.30) seconds, and (4.18 ± 0.59) g/L in the control group ( t = 2.84, 2.33, 2.17, all P < 0.05). There was no significant difference in the incidence of adverse reactions between observation and control groups (5.00% vs. 2.50%, χ2 = 0.00, P > 0.05). There were significant differences in age, body mass index, history of hypertension, and operative time between patients with DVT and those without DVT ( χ2 = 4.11, 5.16, 4.71, 8.65, all P < 0.05). Logistic regression analysis showed that age ( OR = 1.57, 95% CI = 1.239 - 2.014), body mass index ( OR = 6.71, 95% CI = 1.298 - 34.794), history of hypertension ( OR = 3.23, 95% CI = 1.980 - 5.296), operative time ( OR = 6.29, 95% CI = 2.058 - 19.225) were independent risk factors for DVT after joint replacement surgery (all P < 0.05). Conclusion:There are many factors that influence the occurrence of DVT after joint replacement surgery. Intermittent pneumatic compression combined with drugs for prevention of lower extremity DVT is safe and effective.

Objective Toanalyzetheimagingfeaturesofmedulloepitheliomaforfurtherunderstanding.Methods Theimaging findingsof12casesofmedulloepitheliomaprovedbypathologywereanalyzedretrospectively.Results Thelesionswerelocatedin cerebralhemisphere(6),cerebellum (3),ventricularsystem (3),andalloftheminvolvedbothgrayandwhitematter.Thefeatures includedlargegrosstumorvolume,clearboundaryandperitumoraledema(8/12).Othersincludedcystic-solidlesions(11/12),completelysolidlesion (1/12),andiso-orslightlyhyper-densitywithcalcificationonCTscan.ThetypicalfeatureofMRIwas "mid-lakeisland"sign,and solidcomponentshowediso-orhypo-intensityonT1WI,isoorhyper-intensityonT2WIwithhemorrhageandnecrosis,aswellasthe tumorshowedobviousheterogeneousenhancementaftercontrast.Cystcomponentshowedthin-wallring-enhancement.Conclusion Thetypicalfeatureofthemedulloepitheliomaisthe "mid-lakeisland"sign.Thetumorhasalargevolume,andthe majorityshow cystic-solidlesions.Aboveall,medulloepitheliomashouldbeconsideredifthereisasolid-cysticlesionwithclearboundaryatchildren andadolescents.

Objective To investigate the clinical application of chemokine receptor 4 (CXCR4)-targeted PET/CT imaging in breast cancer using 68Ga-1,4,7-triazacyclononane-1,4,7-triacetic acid-TN14003 (NOTA-NFB) and the correlation between 68Ga-NOTA-NFB uptake and pathology.Methods From June 2014 to December 2014,11 female patients (age range:38-68 years) with non-specific invasive breast cancer were recruited in this study.All patients underwent neoadjuvant chemotherapy before surgery.68GaNOTA-NFB and 18F-fluorodeoxyglucose (FDG) PET/CT imaging were performed before the chemotherapy.Three patients also underwent 68Ga-NOTA-NFB PET/CT imaging after the fourth cycle of chemotherapy.The region of interest (ROI) method was used to measure the maximum standardized value (SUVmax) and tumor/non-tumor (T/NT) ratio was calculated.Paired t test and Spearman correlation analysis were used for statistical analysis.Results The SUVmax values of primary lesions were 3.78±2.03 and 8.11±5.14 (t=-3.01,P＜0.05) respectively in 68Ga-NOTA-NFB imaging and 18F-FDG imaging.The T/NT ratios for primary lesions were not significantly different between the two imaging methods (9.36±7.81 vs 15.62±14.51;t=-1.63,P＞0.05).In the metastatic lymph nodes,SUVmax values were not significantly different between 68Ga-NOTA-NFB imaging and 18F-FDG imaging (t=-2.02,P＞0.05),but T/NT ratios were significantly different (t=-2.43,P＜0.05).After neoadjuvant chemotherapy,T/NT ratios were decreased in the 3 patients.Correlation was not found between T/NT in 68Ga-NOTA-NFB imaging and Ki-67,but the P value was close to 0.05 (rs =0.600,P=0.051).Conclusion 68Ga-NOTA-NFB PET/CT can be used as a new CXCR4-targered imaging in diagnosis of breast cancer,and it may be beneficial to evaluate the effect of neoadjuvant chemotherapy.

Objective To compare the renal toxicity of vancomycin with continuous infusion vs intermittent infusion. Methods The databases of EMBASE,PUBMED,the Cochrane Register of Controlled Trials,CBM,CNKI and WanFang were searched.The Cochrane Revman5.2 software was used for Meta-analysis.Results Two RCTs and eight observational studies were included in the systematic literature search with total of 1 764 patients.1 037 patients received vancomycin with continuous infusion while 727 patients with intermittent infusion.The Meta-analysis indicated that there was no significant difference in renal toxicity between continuous infusion group and intermittent infusion group(P>0.05).Conclusion Vanco-mycin continuous infusion cannot effectively reduce the incidence of renal toxicity.

An atmospheric pressure chemical ionization mass spectrometry (APCI-MS) method was developed for the direct analysis of triglycerides in edible oils.The edible oil sample was dissolved in acetonitrile.Under the optimal conditions such as positive ion detection,800 μL/h of sample flow rate,250℃ of vaporizer temperature and 5000 nA of corona needle current,the repeatability (RSD) of peak intensity rate of m/z 857.76 to m/z 881.76 was less than 5％.Then,different kinds of oil from different manufacturers were analyzed by the proposed method.After a principal component analysis for the analytical results,the peak intensity rate of m/z 857.76 and m/z 881.76 was selected for oil identification.The adulteration of 5％ lard in corn oil could be recognized directly using the peak intensity rate.Three characteristic triglycerides in edible oil were preliminarily identified by collision induced dissociation (CID) experiments.The method was applied to analyze the swill oil and fried oil samples,and the results showed that the swill oil contained both vegetable oil and animal fat,and the fried oil was also different with commercial vegetable oil.

Objective To assess whether strain parameters derived from three-dimensional speckle tracking imaging ( 3D-STI) could identify improvement of cardiac function and predict response of patients with immunoglobulin light-chain cardiac amyloidosis ( AL-CA) following chemotherapy . Methods Totally 13 patients with AL-CA [aged (58 .5 ± 8 .9)years;69％ males] were treated with melphalan or bortezomib-based regimens and by regular chemotherapy for 6 months .The clinical data was collected . Maximal left ventricular wall thickness (MLVWT) ,left ventricular mass index (LVMI) ,left ventricular ejection fraction ( LVEF) ,systolic mitral annular velocity ( s′) ,early diastolic mitral annular velocity echocardiography ( e′) , 3D-STI global longitudinal ,circumferential ,radial and area strain (GLS ,GCS ,GRS ,and GAS) ,the standard deviation of time to peak longitudinal strain among 16 left ventricular segments ( TS-SD_GLS ) were obtained by conventional echocardiography and 3D-STI . In addition ,serologic biomarkers including N-terminal pro-brain natriuretic peptide ( NT-proBNP) and free light chains ( FLC) were acquired at baseline and 6 months after chemotherapy . These patients were divided into two groups according to difference of FLC :complete response (CR) group and Non-CR group . The clinical data ,cardiac ultrasound parameters and serological parameters were compared between groups ,each group parameters at baseline and 6 months after chemotherapy were compared within the group.Results ①There were no significant differencein conventional echocardiographic parameters ,GCS ,GRS and GAS ,as well as TS-SD_GLS in either group between before and after chemotherapy . But GLS was improved only in CR group ( P = 0 .036) ,and its improvement was correlated with the decrease in NT-proBNP ( r = -0 .738 , P = 0 .037) . ② In baseline evaluation ,patients in Non-CR group had increased LVMI ,deteriorated e′ and GLS ,and longer Ts-SD as compared to those in CR group ( all P < 0 .05 ) . ③ ROC analysis revealed that these parameters had discriminative ability to forecast those with better therapeutic effectiveness ,esecially for AL-CA patients with baseline LVMI<96 .55 g/m2 ,e′>4 .7 cm/s ,absolute value of GLS>16 .6％ ,and TS-SD_GLS<35 .2 ms ,which may have better hematologic response to chemotherapy . Conclusions GLS can identify early improvement of cardiac function in AL-CA patients after chemotherapy . Moreover ,LVMI ,e′,GLS and TS-SD_GLS are sensitive measurements of pre-treatment ventricular impairment ,and may predict better response to chemotherapy .

Objective Comparing the difference in postoperative recurrence,complications,quality of life and cosmetic results between patients receiving radical mnastectomy and breast conserving surgery,provides an evidence of breast conserving surgery superior to radical mastectomy.Methods A retrospective analysis of 477 breast cancer patients cases in Department of General Surgery,Third People's Hospital of Baoji City from January 2009 to January 2012.These patients were divided into two groups:the control group 229 cases (48％) underwent conservative surgery treatment and the observation group 248 patients (52％) underwent radical surgery.Using SPSS15.0 statistical software analysis and compare with recurrence,postoperative complications,breast cosmetic effect and quality of life for these two groups of patients.Results In breast-conserving group compared with radical mastectomy group,the one and two year recurrence or metastasis rate were not statistically different between the two groups (P ＞ 0.05),the incidence of postoperative complications was significantly decreased (P ＜ 0.05).The scores for quality of life between the breast-conserving group and radical mastectomy group were all significantly different (P ＜ 0.05).Excellent cosmetic results in breast-conserving group was 78.52％,which was significantly higher than that in the radical mastectomy group (61.34％),the difference was statistically significant (x2 =5.86,P ＜ 0.05),The two groups are not significant in overall survival time (x2 =3.154,P ＞ 0.05) and progression free survival (x2 =4.243,P ＞ 0.05) as two indicator of long-term efficacy.Conclusions Conservative surgery compared with radical mastectomyhave less clinical complications,more breast cosmetic effect,better survival quality,and both of them share the same recurrence or metastasis and survival rate,so conservative surgery should be preferable in the clinical application.

Objective To modified doxorubicin liposome with transferrin(TF),and to investigate its inhibition efficacy on the proliferation of human breast cancer cells.Methods The liposome was prepared by thin film ultrasonic,and doxorubicin liposomal was prepared by sulfuric acid gradient.The TF-doxorubicin lipo-some was prepared by the post insertion method.The uptake of TF-liposomal doxorubicin on breast cancer cells MCF-7 and MDA-MB-231 were detected by confocal microscopy.The killing ability of TF-doxorubicin liposomal targeting for MCF-7 and MDA-MB-231 were detected by MTT assay.Inhibitory effect of TF-doxorubicin lipo-some on the growth of MCF-7 and MDA-MB-231 were detected by soft agar colony assay.Results Confocal microscopy result showed that the uptake of TF-liposomal doxorubicin on MCF-7 and MDA-MB-231 were signifi-cantly higher than doxorubicin liposomal.Cell-killing ability on MCF-7 and MDA-MB-231 showed that the IC50 in TF-liposomal doxorubicin [MCF-7 cells:(20.8 ±3.2)μmol/L;MDA-MB-231 cells:(20.1 ±3.0)μmol/L)] were significantly lower than the liposomal [(1 58.6 ±24.6)μmol/L;(1 60.1 ±25.1 )μmol/L)]and free doxorubicin [(1 61 .7 ±26.2)μmol/L;(1 66.9 ±27.0)μmol/L)],with significant differences(F =1 1 6.03, P <0.001 ;F =75.29,P <0.001 ).Soft agar colony assay showed that the inhibition of TF-doxorubicin lipo-some on colony growth were significantly higher than doxorubicin liposome,free doxorubicin and control [dia-meter of MDA-MB-231 cells:(60.5 ±10.4)μm,(94.3 ±16.8)μm,(1 31 .8 ±22.6)μm,(162.8 ±30.3)μm;diameter of MCF-7 cells:(31 .8 ±5.5)μm,(62.1 ±11 .1 )μm,(108.6 ±1 8.6)μm,157.4 ±29.3)μm],with significant differences (F =87.17,P <0.000 1 ;F =178.23,P <0.000 1 ).Conclusion TF-doxorubicin lipo-some has a significant inhibitory effect on the proliferation of breast cancer cells in vitro,and can effectively and specifically kill the breast cancer cells,which provides theoretical basis for the treatment of breast cancer in vivo.

Objective To study conventional laparoscopic instruments line single hole peritoneoscope gallbladder excision and three hole laparoscopic cholecystectomy surgery efficacy and safety.Methods 140 cases patients with gallbladder stones in our hospital from January 2014 to June 2015 were selected as the research subjects.All patients need to be treated with cholecystectomy.All the patients according to the random number table were randomly divided into two groups,respectively for single hole group and three group.Single hole group using a single hole peritoneoscope gallbladder excision,triplex group use three hole laparoscopic gallbladder resection.The surgical effect,hospitalization costs and complications were compared between the two groups after treatment.Results Hole group operation time (87.89 ± 12.81) min,longer than the three-hole group (53.89 ± 8.91) min,but the hospital stay was (1.28 ± 0.21) d and total hospital costs (11 241.21 ± 23.91) yuan,were lower than three-hole group,P ＜ 0.05,the difference was statistical significance in the amount of bleeding in the two groups were not statistical significance,P ＞ 0.05;two groups of patients had complicatiom,but have been treated better,and two concurrent disease (1.43％ vs 2.86％) incidence was no significant difference,P ＞ 0.05.Conclusion Single hole laparoscopic cholecystectomy reduce the hospitalization time and hospitalization expenses,surgical trauma is smaller,postoperative recovery is faster,and the safety is high,it is worthy of clinical application.

ObjectiveTo systematically evaluate the advantages and disadvantages of choledochoscopic gallbladder-preserving cholelithotomy (CGPC) and laparoscopic cholecystectomy (LC) in the treatment of gallstones. MethodsThe databases of CBM, CNKI, VIP, Wanfang Data, PubMed, EMBASE, the Cochrane Library, and Web of Science were searched for randomized controlled trials (RCTs) related to CGPC and LC in the treatment of gallstones published up to June 2015. Data extraction and quality evaluation were performed for the literature included, and Review Manager 5.3 was used for the meta-analysis. ResultsFive RCTs involving 685 patients were included. The results of the meta-analysis showed that CGPC group and LC group had significant differences in operation time (OR=8.85, 95% CI: 049-17.21, P=0.04) and incidence of postoperative diarrhea (OR=0.24, 95% CI: 0.11-0.53, P=0.000 4). However, no significant differences were seen between the two groups in intraoperative bleeding volume (OR=-12.37, 95% CI: -29.73-4.99, P=016), time to postoperative intestinal function recovery (OR=-7.19, 95% CI: -24.28-9.90, P=0.41), hospitalization days (OR=-0.17, 95% CI: -1.98-1.63, P=0.85), and hospital costs (OR=-1.14, 95% CI: -2.57-0.28, P=0.12). ConclusionThe operation time and incidence of postoperative diarrhea in CGPC are superior to those in LC, while no significant differences are observed in intraoperative bleeding volume, time to postoperative intestinal function recovery, hospitalization days, and hospital costs. Due to a limited number of articles included and publication bias, RCTs with a large sample size and high quality are needed to provide more effective data.